Please use this form to submit a request for a support letter or report, even if you’ve spoken to your clinician about the request. We ask that all requests are submitted via this from, so it can be added to the document queue and an invoice generated. We may contact you if additional information is required. Please provide your psychologist with a minimum of 2 weeks to complete your request.

Support Letter and Report Request Form

To ensure accuracy, treatment reports and support letters can only be prepared by your clinician if you have attended 3 or more appointments.

A fee of $200 per hour is charged for your psychologist’s clinical expertise and time taken to prepare reports and support letters. A one page letter typically takes between 30 minutes to an hour, so costs between $100 to $200. Comprehensive or assessment reports typically take 4 to 8 hours of work. Medicare rebates are not available for reports or support letters.

Reports and support letters will take a minimum of two weeks from the date of request. Our clinicians all work part time and spend most of their working hours in sessions with clients. We require two weeks notice to book the document preparation into their schedule, balancing this with requests from clients needing extra or early appointments. This timeframe may also be impacted by annual leave, sick leave, or other client reports and emergencies.

What is your name? *

First Name

Last Name

What is your email? *

What type of document do you require? *

Support Letter (often required when seeking consideration with study challenges, employment issues etc.)

Comprehensive Report (detailing assessments, diagnoses, treatments etc.)

NDIS Initial Report (detailing the evidence and clinical opinions regarding impairments that may qualify for NDIS support)

NDIS Review Letter (often requested by the NDIA for clients with existing NDIS plans)

What date is the document required? *

All documents will take a minimum of two weeks from the date of request

YYYY

Name of person to whom the document is to be addressed

First Name

Last Name

Name of organisation to whom the document is to be addressed

Relevent reference number

E.g. claim number, NDIS participant number, student number etc,.

What information do you authorise us to provide in the requested document?

Select all that apply

Length of engagement with Next Chapter Health

Frequency of sessions

Symptoms

Diagnoses

Impairments caused by any mental health challenges

Treatments

Outcomes

Recommendations

Please provide any additional information regarding the requested document

Important Information *

Next Chapter Health is not a crisis service. If you require urgent support please contact Lifeline on 13 11 14 and call 000 for all emergencies. By submitting this form you confirm that your need is not urgent and there is not a current risk to your safety. By completing this form, you authorise us to contact you using the details above and confirm you are aware of the document preparation timeframes and fees, available at www.nextchapter.health/fees.

Yes, I confirm that I understand and agree to the above points

Thank you!

Next Chapter Health • fax: 03 8672 0228 • email: hello@nextchapter.health

Next Chapter Health acknowledges and pays respect to the past, present and future Traditional Custodians and Elders of the land on which we work, the Wurundjeri people of the Kulin Nation. We recognise and support the continuation of cultural, spiritual and educational practices of all First Nations people.

Next Chapter Health proudly supports the LGBTQIAP+ (Lesbian, Gay, Bisexual, Transgender and Gender Diverse, Intersex, Pansexual, Queer, Asexual, BrotherBoys, SisterGirls) community. You are seen, you are heard, and you are welcome here.