Client details

    First name

    Surname

    Date of birth

    Details of person whose credit card is being charged

    First name

    Surname

    Email

    Mobile number

     

    Inner Melbourne Clinical Psychology’s cancellation and rescheduling policy
    
I am aware if an appointment is changed or rescheduled within 48 hours, unless there is an emergency I will be charged the full fee for this session. Please note that Medicare and private health insurance do not provide rebates for cancelled or unattended appointments.

     

    Arrangements for payments, invoicing and rebates

    • Credit card details will initially be given to an Inner Melbourne Clinical Psychology Support Team member over the phone. These will then be stored in our secure system for future use.
    • You will be provided with an invoice after each payment is made. It is important that the client understands that this means you will then know when they attend sessions. If the client would like their attendance to remain confidential, other payment arrangements will need to be made.
    • If the client has a Medicare referral, their psychologist will speak with them about making arrangements for whose bank account the rebate is sent to (the client’s or your own)
    • We will process the rebate on the same day as your payment. Please allow three business days for the rebate to come through.

     

    I give permission for payments for the client's sessions to be deducted from my credit card, details of which will be given to an Inner Melbourne Clinical Psychology Support Team member over the phone.