Form

Welcome to Our GP Referral Kit Request!

At Dokotela, we are dedicated to supporting healthcare professionals like you, who play a vital role in enhancing mental health and patient well-being.

We are pleased to provide you with informative flyers and referral materials designed for both you and your patients, containing clear and concise information about our telehealth psychiatry service.

We believe these materials will be a valuable addition to your practice, offering accessible information to enhance patient care and streamline the referral process.

Referral Kit Mode*

Digital

Physical

Both

Would you be informed on our wait times and new specialists (via our monthly newsletter)? *

Yes

Are you currently referring to Dokotela?*

Yes

How did you hear about the Referral Kit?*

Contact Information

First name*

Last name*

Email*

Job Title*

Clinic Information

Physical resource packs will be sent to your clinic (at no cost to you).

Clinic Name*

Number of GPs at Clinic*

Clinic Phone Number*

Street Address*

State*

Postcode*

By submitting, I agree to the Privacy Policy, Terms of Service, and Zero Tolerance Policy.