Mind & Brain Clinic

Innovative Care for Better Mental Health

Form 029

by | 29 Sep, 2024

M&B Form 029 Travel Letter Request

Name(Required)
Letter Fee
Terms and Conditions - Emergency Care(Required)
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M&B Form 028 Document Upload

Use this form to upload updated referrals, assessments or other documents we have requested.

Name(Required)
Drop files here or  
Max. file size: 30 MB, Max. files: 3.
    This field is for validation purposes and should be left unchanged.

    M&B Form 027 Script Request

    Script Policy(Required)
    Name(Required)
    Script Fee
    Terms and Conditions - Emergency Care(Required)
    This field is for validation purposes and should be left unchanged.

    M&B Form 004 - Preauthorization

    Use this form to preauthorize appointment fees up to 6 days before your appointment date.

    Name(Required)
    This field is hidden when viewing the form
    New Patient or Existing Patient?
    New patients include those that have not completed the intake and first and second psychiatrist appointments.
    Appointment Fee(Required)
    PrevNext
    MoTuWeThFrSaSu
    242526272812
    3456789
    10111213141516
    17181920212223
    24252627282930
    31123456
    DD slash MM slash YYYY
    Preauthorization opens 6 days before the appointment date.
    Terms and Conditions(Required)

    M&B Form 003 Registration

    Confidential

    Have you received an email from Mind & Brain offering you an initial appointment?

    M&B Form 002 Referral Upload

    Name(Required)
    DD slash MM slash YYYY
    • Australia+61
    Basic Information
    YesNo
    Resident of Western Australia
    My Referral has already been sent to Mind & Brain by my GP
    Drop files here or
    Max. file size: 30 MB, Max. files: 3.
      Terms and Conditions(Required)
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      M&B Form 012 ADHD Assessment and Treatment Process

      Form 012 ADHD Assessment and Treatment Process
      Effective 3 March 2025


      ADHD Assessment Process


      The fee for an ADHD assessment is $1,200 less Medicare rebates of $386.75 making a total out of pocket cost of $813.25.

      An ADHD assessment would require at least two meetings with a psychiatrist at the clinic. 

      We will send you some scales and questionnaires to complete prior to your first appointment and it is expected to be returned at least a week before to your appointment. 

      The first appointment will take about one hour. If you have any school reports available, please bring them. We encourage reading your school reports in advance and prepare to show teachers comments suggestive of ADHD or other difficulties. We understand that some people have no access to their school reports, and it should not affect your assessment.  

      Collateral information is required for a diagnosis, and we encourage you to bring a family member or someone who knows you well. We understand that in some cases it might be difficult or not possible. Please let us know and we can try to arrange an alternative way to obtain a collateral information (for example a phone call outside of your meeting with a doctor).

      Second appointment – Discussing your diagnosis, management plan, and starting treatment if treatment is indicated. 

      Urine drug test is a mandatory requirement before starting ADHD medication (stimulants) and can be completed at CliniPath following a referral from our psychiatrist.

      If treatment with ADHD medication is indicated but cardio-vascular risk factors are identified, our psychiatrist might need to organise a referral for an ECG (electrocardiogram) or referral to a specialist. Some patients may require further medical input (GP, cardiologist or other specialists) before starting treatment with ADHD medication. 

      Follow up Appointments:

      After stimulant treatment commencement, regular follow-up appointments would be required. The frequency of appointments varies depending on your presentation and complexity. most common schedule is a first review three months after treatment initiation, and then 6 monthly. 


      Would you like a copy of the process emailed to you?
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      M&B Form 006 Financial Disclosure

      Financial Disclosure 
      Effective 3 March 2025

      Mind and Brain is a private medical practice and aims to provide optimal care for each individual patient. Occasionally our practice fees are adjusted to reflect changes in Medicare rebates, practice costs, wages, and new items. From 3 March 2025 Practice Fees are as below.

      Description
      Fee
      		 Rebate Gap




      ADHD assessment (two appointments)
      1,200.00
      		 386.75 813.25
      Follow-up appointment with a psychiatrist - standard
      250.00
      		 85.00 165.00
      Follow-up appointment with a psychiatrist - extended
      350.00
      		 130.85 219.15
      Follow-up appointment with a psychiatrist - long
      600.00
      		 255.90 344.10
      Script outside of appointment
      60.00
      		 - 60.00
      Letter for travel or confirmation of medication
      44.00
      		 - 44.00
      Letter to third party
      Varies
      		 - Varies

      A $250 deposit is required to secure your appointment. 

      Medicare rebates apply to all consultations with our psychiatrist. 

      If you intend to claim any refunds through your private health insurer, please check if they provide cover for outpatient psychiatry appointments in advance. 

      We will send you reminders for your appointments and information how to pay online a week before each appointment.

       All follow up appointments must be preauthorized up to 6 days before each appointment and not later than 1 day before your appointment. 

      If you wish to cancel or move your appointment, we request you provide as much notice as possible and not less than one weeks’ notice for initial appointments. Missing an initial appointment or providing less than one weeks’ notice to cancel or move will incur a $250 fee. 

      Missing a follow-up appointment or cancelling or moving with less than 24 hours’ notice will incur a $100 fee. If you need to change an appointment, please let us know as soon as possible. We have Telehealth facilities available for follow up appointments if you are Covid positive, have cold and flu symptoms but are still feeling well enough to attend.

      Would you like a copy of the financial disclosure emailed to you?
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      M&B Form 030 Appointment Request

      Name(Required)
      Appointment Type(Required)
      YesNo
      9am to 10am
      10am to 11am
      11am to 12pm
      1pm to 2pm
      2pm to 3pm
      3pm to 4pm
      YesNo
      9am to 10am
      10am to 11am
      11am to 12pm
      1pm to 2pm
      2pm to 3pm
      3pm to 4pm
      Note we will do our best to accommodate preferences but cannot guarantee we will be able to provide an appointment at your preferred time.
      Terms and Conditions(Required)
      This field is for validation purposes and should be left unchanged.