Contact Us Address80 College Hill, Fremans Bay, Auckland Emailmissy@empowerment-psychology.com Phone+1 234 56 78 123 +1 234 56 78 123 Work hoursMon to Fri 8 am - 6 pm Sat to Sun 9 am- 2 pm Take Care of Your Mental Health Please enable JavaScript in your browser to complete this form.Are you completing this referral for yourself or for another person?For myselfFor another person (I have consent from the person to make this referral)For a child (under 18 years old and I'm the legal guardian/caregiver)Name of the client *FirstLastYour name if you are referring someone elseFirstLastClient's age *Email *Phone Number *Best time to contact via phone during the work weekMorning (8 AM - 12 PM)Afternoon (between 12 PM-5 PM)Services required (if unsure, please leave blank and we'll help triage your referral)Psychological Assessment and TherapyADHD assessmentAutism assessmentAutism and ADHD assessmentEducational/Learning AssessmentWorkshops/Training/SupervisionWho would you like to see? I don't mind - whoever has the earliest availabilityDr Jane Cha (Tue & Friday) - Adults onlySam Patel (Monday-Thursday) - Senior Psychologist rate & Adult Client onlyNadjela Salimi (Tue & Thu evening, Saturday) - Children and AdultsDana Lee - assessment only for children and adultsHeba Mortaja (Mon, Tue, Thu & Friday) - Children and AdultsJade Fersterer (Tue) - Educational/Learning Assessment only for children and adultsJenny Parsons (Wed telehealth, Friday in-person) - Adults onlySummary of concerns - please outline your symptoms or concerns and how long they have been presentPrior treatment (if any)Our goal is to provide an inclusive and accessible environment for all our clients. To help us prepare for your in-person appointment, please inform us of any specific accommodations you may require in advance. Please note that there are steps to get to the entrance of our clinic on College Hill. Reasons for seeking help at this time?Who do you go to support for currently? e.g. friends, family?Due to our limited availability we are not able to see clients who are presenting with: severe level of mental health symptoms, high risk of harm to self or to others, borderline personality traits or disorder, eating disorders, bipolar, schizophrenia or psychosis related presentations. We are also not able to see Families with parenting orders or custodial issues that may end up in Family Court.Please tick to indicate that you have read the service criteria above and you meet these eligibility requirements. *Yes, I understand.Send Message
