check

Asian Australian Mental Health Practitioner List Form

If you are a registered Asian Australian mental health practitioner who is interested in being listed on the Asian Australian Mental Health Practitioner List, please fill out this form.

Questions asked in the form:

- Name
- Your profession
- Your professional board/body/organisation that you're registered with
- Your registration number
- Website
- Your location
- Best contact email
- Best contact phone number
- Areas of specialty/expertise
- Best contact email to liaise with Shapes and Sounds
- Acknowledgement of terms

Click the button below to start.

Each question is required. If n/a, please type "n/a".

Start

Question 1 of 12

Name:

Question 2 of 12

Your profession. (eg. Clinical Psychologist)

Question 3 of 12

The professional board/body/organisation that you're registered with.

A

AHPRA: Australian Health Practitioner Regulation Agency

B

AASW:Australian Association of Social Workers

C

OTA: Occupational Therapy Australia

D

PACFA: Psychotherapy & Counselling Federation of Australia

E

ACA: Australian Counselling Association

F

Other: Please outline in the final "notes" question.

Question 4 of 12

Your registration number with your relevant board/body/organisation: (Eg. Your AHPRA number)

Question 5 of 12

Website URL: 

Question 6 of 12

Best contact email (for potential clients):

Question 7 of 12

Best contact phone number (for potential clients):

Question 8 of 12

Your location (suburb and state):

Question 9 of 12

Areas of specialty/expertise:

Question 10 of 12

Best contact email (to liaise with Shapes and Sounds):

Question 11 of 12

Any other notes that you would like to add:

Question 12 of 12

Listing your details on this site costs $240.00 AUD per year.

 

Support and networking:

 

This fee includes free admission to our quarterly peer supervision sessions for Asian Australian mental health practitioners. These sessions are facilitated on Zoom on weekday evenings.

 

Marketing assistance:

 

Additionally, this fee will include your details being sent to our mailing list of 1300+ therapy ready clients every month. The list is also shared fortnightly on our social media platforms with 4000+ targeted followers.

You will also be eligible to promote your practice further by sharing a short Q&A with Shapes and Sounds.

 

Conditions:

Your details will be listed within three business days of receipt of payment.

 

Your payment includes a 3 month trial and you are able to cancel your payment before your trial expires. 

 

Shapes and Sounds reserves the right to adjust these terms to better serve our community.

A

Check to acknowledge your understanding of these terms.

Confirm and Submit