Submit Funding Pre-Approval

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For Doctors · Submit an Enquiry or Request · Bundall  ·  Telehealth Australia-wide
05 Submit Funding Pre-Approval Third-party funders · upload required +

Use this form to securely submit formal funding pre-approval documentation for psychological services (e.g. initial psychological assessment consultations, psychological therapy, clinical assessment, psychometric testing, psychological reports) and dietetics services (e.g. initial and subsequent consultations, meal plans, reports).

This is for
✦Clients who have already received written funding approval from a third-party funder, or
✦Funding bodies, insurers, case managers or support coordinators submitting approval directly to us

Please ensure the approval documentation clearly outlines the approved services, funding limits, validity period, and any billing conditions.

Submission of this form does not guarantee service availability or acceptance of funding. All funding approvals must be reviewed and confirmed by our clinic before services can commence.
If your question is not related to submitting formal funding approval, please refer to our FAQs or select the appropriate request form.
Submit Third-Party Funding Pre-Approval
I am submitting this funding pre-approval as:

Your Details

Your Name
Your Name
First Name
Last Name

Client's Details

Client's Name
Client's Name
First Name
Last Name

Funder Details

Funder Case Manager / Contact Person
Funder Case Manager / Contact Person
First Name
Last Name

Nature of Pre-Approved Services

Services Approved (tick all that apply)
0 of 200 max words

Maximum file size: 10MB

Who will be invoiced?
Consent & Acknowledgement. I understand that: