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Asian Australian Mental Health Practitioner List Form

If you are an Asian Australian psychologist or mental health social worker 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
- AHPRA or AASW registration number
- Your profession
- 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 11

Name:

Question 2 of 11

AHPRA registration number:

Question 3 of 11

Your profession:

(Select all that apply)
A

Registered psychologist

B

Clinical psychologist

C

Clinical psychology registrar

D

Accredited Mental Health Social Worker

E

Organisational psychologist

F

Forensic psychologist

G

Educational and developmental psychologist

H

Provisional psychologist

I

Other

Question 4 of 11

Website URL: 

Question 5 of 11

Best contact email (for potential clients):

Question 6 of 11

Best contact phone number (for potential clients):

Question 7 of 11

Your location (suburb and state):

Question 8 of 11

Areas of specialty/expertise:

Question 9 of 11

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

Question 10 of 11

Any other comments that you would like to add:

Question 11 of 11

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

 

This fee will include your details being sent to our mailing list of 500+ therapy ready clients every month. The list is also shared fortnightly on our social media with 2000+ targeted followers. You will also be eligible to promote your practice further by sharing a short Q&A with Shapes and Sounds.

Once there are 60+ practitioners on the list, your fee will also cover networking and peer-support opportunities.

You will receive a 3-month trial period from the date your details are listed, before payment is required. Payment is via credit card or bank transfer.

 

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