To be completed by medical professionals

Clarion Clinics is a nation-leading mental healthcare provider, focused on delivering best-in-class assisted therapies within the Authorised Prescriber scheme. Our first clinic is located in Abbotsford, Melbourne (VIC, Australia), and commenced operation in 2024. The team at Clarion Clinics has Australia’s strongest track record in delivering assisted therapies within clinical trials and is approved by federal and state authorise to provide this specialist treatment.

This referral form can be completed by a prospective client’s treating doctor as part of eligibility screening. 

For questions or referral support please contact  info@clarionclinics.com or phone us on (03) 9828 7566.

Please consider that to be eligible for treatment your patient must:

• Be 18 years or older

• Have a current diagnosis of major depressive disorder and/or post-traumatic stress disorder

• Have previously tried medication as part of their treatment without adequate benefit

• Be able to attend frequent in-person treatment sessions at the clinic in Abbotsford for period of approximately nine months

Optional:

Optional:

If relevant, please upload any reports or supporting documents below: