Enquiry Form

Change Futures enquiry form for psychological services.

This form is designed for individuals seeking assistance for themselves. If you are making a referral on behalf of someone else, please use the referral form instead.

Cyclone Alfred Update: Office Closure & Support Information
To ensure the safety of our community and practitioners, our offices will be closed on Thursday and Friday.

Clients with appointments on these days have been offered telehealth where possible.
Our support teams will work remotely to answer calls and manage urgent referrals.

If you need to reschedule or have any concerns, please contact the office. We expect to reopen on Monday, 10 March, pending any further weather impacts. Updates will be posted here as needed.
For urgent support, please reach out to:

Lifeline – 13 11 14
MHCALL (QLD) – 1300 642 255
NSW Mental Health Line – 1800 011 511

Please take care and reach out if you need support.

Your Contact Information

Family Name: Given Names: Preferred Pronouns:

Return Contact Details

Phone/Mobile: Email address:

Consent

I consent to receiving a return call from Change Futures: I consent to receiving a voice message or SMS: Region where I live:

Service

If you are unsure what service to select, please select Private Practice.

Select a service:

Submission Instructions

Please finalise your submission by clicking the "Submit" button below. Thank you.

Please enter the correct letters.