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GP Referral Form

Contact Safecircles Counselling

To book an appointment, please contact Karin at Safecircles Counselling.

  • Telephone 0402318281 - please leave a message or send an SMS if unanswered

  • Email safecircles@iprimus.com.au

  • Ask your GP to complete the form below if you are accessing sessions via a mental health care plan.

Referral to Karin Dewar, Accredited Mental Health Social Worker (AMHSW) with a GP Mental Health Care Plan.


Safecircles Counselling

Therapy Central

Subiaco Mews, Suite 22

375 Hay Street, SUBIACO WA 6008


Karin Dewar MSW, AMHSW, B.AppPsych. B.Couns.

T: 0402318281

E: safecircles@iprimus.com.au

W: www.safecircles.com.au

Medicare provider number; 4709033K

I refer the above patient under a GP Mental Health Care Plan.

Unless otherwise stated, this referral is valid for:

  • SIX sessions (includes progress report after sixth session) or upon earlier discontinuation.

  • A further FOUR sessions may be considered after GP review (total of TEN sessions allowable in any one calendar year).

ABN 71 518 269 610                 

 Medicare Provider Number 4709033K                 

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