Book Now: New Couples Counselling Client

To request a couples appointment, please complete the enquiry form below. Our friendly Support Team will be in touch within two business days (usually sooner) about whether we have a therapist who’s the right fit for you. 

If you have any trouble using this form, please get in touch.

A note about couples therapy and safety

Couples therapy can be a powerful way to reconnect and work through challenges together. But sometimes the dynamics in a relationship go beyond everyday conflict. If there’s a pattern where one or both of you feel fearful, controlled, attacked, unsafe, shut down or like you’re constantly walking on eggshells, even if it’s subtle or hard to name, couples therapy may not be the safest option right now.

This might include things like frequent yelling, name-calling, threats, manipulation or one person feeling like they have to monitor what they say or do to avoid upsetting the other. It might also include other people in your life being concerned about your relationship. In situations like these, couples therapy can unintentionally increase risk and make the situation worse. Because of this it’s often more helpful for each person to focus on their own individual support or to continue building on the support they already have in place.

If any of this resonates with your experience, before completing this form we encourage you to read this short article. It explores why couples therapy isn’t always the right fit and what alternatives might be more appropriate. We know your time and energy are valuable and this blog may help clarify whether couples therapy is the best path for you right now.

If you complete this form and we think you’re not suitable, even if you disagree, we will refer externally.

Couples therapy booking form

Before you complete this form, please note that:

  • IMCP does not provide crisis services or immediate appointments, court reports, one-off assessments or services via third parties. For support during a crisis, please click here.
  • Some questions in this form ask about conflict, control and safety in your relationship. If your responses indicate that a child may be at risk, we’re legally required to make a report to child protection, even when someone is seeking help in good faith. We take this responsibility seriously and handle all concerns with care and respect.
  • The questions in this form help us to match you up to the right team member. Some are optional and some are required to make a booking.

    * required

    Your first name*

    Your surname*

    Your preferred name

    Your pronouns, if you feel comfortable to share them with us (e.g. she/he/they)

    Your mobile number*

    Your email*

    Your current address*

    Street address

    Suburb

    Postcode

    How did you hear about Inner Melbourne Clinical Psychology?*

    Date of birth (day/month/year)*

    To book you in, we will need the following details about your partner:

    Please be aware that if you do book an appointment with us, we will contact both yourself and your partner with appointment details and information.

    Partner's full name*

    Partner's preferred name

    Partner's pronouns, if they feel comfortable with you sharing them

    Partner's date of birth*

    Partner's phone number*

    Partner's email address*

    Partner's current address*

    What does your partner think is the key reason for coming to couples counselling?*

    All of our counsellors are LGBTQIA+ affirmative, but if you would like to work with someone who also has specific training and experience in working with these communities, please tick this box and we'll ensure you're matched with someone who is suitable.
    Yes, I would like to be matched with a counsellor trained and experienced with LGBTQIA+ communities.

    Please tick the issue/s you would like help with (please select at least one issue)*

    Please be aware, if you or your partner are involved with court proceedings or engaged with a lawyer, or if either of you think you may be in the future, we will not be able to provide therapy in this case.

    Please provide us with some brief information in relation to the following questions.

    What do your fights look like? For example, is there yelling, breaking things, threats, name calling or physical aggression?*

    Do you ever feel unsafe in your relationship?*

    Does your partner ever tell you that they feel unsafe in the relationship?*

    Do you ever feel controlled by your partner?*

    Does your partner ever tell you that they feel controlled by you?*

    Has anyone else ever been concerned about your safety in this relationship?*

    Has anyone else ever been concerned about your partner’s safety in this relationship?*

    Do things ever feel out of control in your relationship?*

    How ready do you feel you and your partner are to work on these challenges?*

    Please provide us with some brief information in relation to the following questions.

    Can you tell us briefly about the concerns you have about abuse or behaviour that may have crossed a line?*

    Do you ever feel unsafe in your relationship?*

    Does your partner ever tell you that they feel unsafe in your relationship?*

    Do you ever feel controlled by your partner?*

    Does your partner ever tell you that they feel controlled by you?*

    Has anyone else ever been concerned about your safety in this relationship?*

    Has anyone else ever been concerned about your partner’s safety in this relationship?*

    Do things ever feel out of control in your relationship?*

    How ready do you feel you and your partner are to work on these challenges?*

    What do you think the key reason for coming to couples counselling is?*

    Are you currently separated or on a break? Please provide some details about this.*

    Are you or is your partner currently thinking about ending your relationship? Please provide some details about this.*

    Please let us know if there is any other information that you think it would be helpful for us to know when matching you up with one of our couples counsellors.

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