Enquiries & referrals

Send a referral, or an enquiry.

A simple, secure way to get in touch, whether you’re reaching out for yourself, for someone you care for, or as a referrer.

Fill in a few details and we’ll reply by your preferred contact method. A brief, general note is all we need here. There’s no need to share detailed health information at this stage. If you’d rather, you can email the clinic, and clients ready to book can book online via Halaxy.

Leave this field empty:

Who is getting in touch? * I am a prospective client I am a family member or carer I am a referring professional

Your name *

Email *

Phone (optional)

Your location / state (for telehealth)

Best way and time to reach you

How did you hear about us? (optional)

What are you reaching out about? *

A short, general note is perfect, such as the kind of support you’re looking for. Please don’t include detailed health, clinical or sensitive information here. We’ll gather anything we need securely once we’re in touch.

If you’re a referring professional (optional)

Only complete this part if you’re referring someone. Please confirm the person has consented to this contact, and keep clinical detail out of this form. Full referral information can follow by secure email.

Your profession / organisation

Client’s first name or initials

Likely referral pathway

I confirm the person has consented to this contact

I have read the privacy note below and understand not to share detailed health or sensitive information through this form. *

How your information is handled

This form is for first contact only. We deliberately keep it to brief, general details so that sensitive health information isn’t shared through a website form. Submissions are transmitted over a secure connection and handled only by the clinic. Once we’re in touch, any clinical or personal information needed for your care is collected through our secure practice system (Halaxy), in line with the Australian Privacy Principles and our Privacy policy. If you’d prefer not to use this form, email admin@bodybelongingclinic.com.au.

Safety note

This is not a crisis service.

Body Belonging Clinic is not an emergency or crisis service, and this form is not monitored at all times. If you or someone else is in immediate danger, call 000. For 24/7 crisis support in Australia, contact Lifeline on 13 11 14. Aboriginal and Torres Strait Islander people can contact 13YARN on 13 92 76. Children and young people can contact Kids Helpline on 1800 55 1800. For eating disorder support, contact the Butterfly Foundation National Helpline on 1800 33 4673.