Book Now: New Couples Counselling Client

To make a couples appointment, complete the enquiry form below. Our friendly support team will be in contact within seven days (usually sooner).

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

Make a booking form

* required

Please tick below to show that you understand the following:

I understand that IMCP does not provide crisis services or immediate appointments (please instead click here), court reports, one-off assessments or services via third parties (please click here)*.

These questions help us to match you up to the right team member. Some are optional, and some are required to make a booking.

Your first name*

Your surname*

Your pronouns (e.g. she/he/they)

Your mobile number*

Your email*

How would you like to be contacted?*
Unfortunately if you don't feel comfortable for us to contact you via either phone or email we are not able to assist you. If the reason you don't feel comfortable with us contacting you via either of these methods is due to family violence, we'd recommend you contact 1800 RESPECT on 1800 737 732 for further assistance.

Phone callEmailEither, I don't mind

Your current address*

Street address

Suburb

Postcode

How did you hear about Inner Melbourne Clinical Psychology?*

Date of birth (day/month/year)*

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.

How would you like to see a couples counsellor?*
With my partnerBy myself

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 pronouns

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?*

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

Communicate more effectivelyBring your relationship to life againSupport each other more effectively during stressful timesBring some playfulness and spontaneity back into your relationshipUnderstand the way that your past might be causing challenges within your relationshipExplore issues such as finances, parenting and troubles with extended familyBuild trust and emotional connectionAcknowledge each other’s needs and find ways of meeting themRevive parts of your relationship that have been neglectedDevelop a deeper understanding of yourself and your partnerFeel clear on the future of your relationshipNavigate conflict more effectivelyManage perpetual problemsRegulate difficult emotions (including managing trauma)Cope with stress and triggersFind a life balanceNavigate different values or cultural differencesWork with mismatched desire or loss of intimacyManage life transitionsRecover from affairs or infidelityNavigate ethical non-monogamyDecide whether to stay or leave in a relationshipLearn from previous relationshipsReconnect as partners and parents after the arrival of childrenLearn from previous relationshipManage mental health in your relationshipAffirm your gender and/or sexualityExplore your relationship values, needs and rightsProcess a separation or divorce

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.

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.