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Is Practice 371 the right place for me?

We are able to work with you if you meet the following:

You are 12 years and older. We are unable to see those under 12 at this time.
You are not seeking specific strategies for weight loss and dieting.
If you are seeking therapy for an eating disorder, you are medically stable and have regular reviews with your GP.
If you are at a low weight, you have a BMI above 16.5.
You do not require urgent care or have any significant medical complications from an eating disorder.
You are not currently actively suicidal and therefore more suited to a higher level of care than we provide.

New Client Appointment Request Form

We are currently open to new referrals for adolescents and adults. Our wait time is 1-4 weeks.

To request an initial appointment please complete the form below. GPs and other health professionals are also welcome to use the form or to send us a written referral directly. All new referrals will be discussed in confidence by our team.

For general or administrative enquiries, please feel free to contact us on admin@practice371.co.nz

Appointment fees can be found here.

I am completing this form for:

Referrer Name (if applicable)

First Name

Last Name

Client Name

First Name

Last Name

Preferred pronouns

Ethnicity

Phone

Age

We are currently only seeing clients over 12yrs

Date of birth

YYYY

GP (Name and Practice)

I am based in:

Preference for in person or online

Please note that we may not able to accommodate your preference

In Person

Online

Summary of concerns

Please outline your symptoms or concerns and how long they have been present. Please include any weight changes in the past six months.

Prior treatment (if any)

Please include therapy and medications

Reasons for seeking help at this time?

How did you hear about our service?

Please tick to indicate that you have read our service criteria above and you meet these eligibility requirements

Yes

Visit Us

admin@practice371.co.nz

Level 2 | 371 Parnell Road
Parnell, Auckland 1052

Unfortunately, our building does not have a wheelchair or lift access. If this is likely to prevent you from being able to attend appointments and you are open to online therapy, please let us know.