PsyAx TAC referrals

Online Referrals

At PsyAx we offer neuropsychological assessments to people who have Transport Accident Commission (TAC) funding. These services are fully funded by TAC. You can have an assessment via telehealth, at home, or in our office.

You can make a referral for yourself or another TAC client by completing the form on this page. We will need to get approval of funding from TAC before commencing services.

Submit an Online Referral

CLIENT DETAILS

* Indicates required field

Client name *

First

Last

Client date of birth (dd/mm/yyyy) *

Client TAC number *

Client phone number (optional) *

Client email address (optional) *

SUPPORT PERSON

Is the appointment to be organised through a support person? *

Yes, please contact the support person to arrange No, please contact the client directly

Support Person name *

First

Last

What is their relationship to the client? *

Support Person phone number *

Support Person email address *

Referrer Details

Referrer name *

First

Last

Organisation *

Referrer email address *

Referrer phone number *

Upload referral letter (optional) *

Max file size: 20MB

Brief notes on referral *

Submit

New TAC Clients

Online Referrals

Submit an Online Referral

CLIENT DETAILS

SUPPORT PERSON

Referrer Details