Refer a Client

We make referrals straightforward. Alex Crouch Counselling welcomes referrals from GPs, allied health professionals, lawyers and legal professionals, NDIS support coordinators, schools, and workplaces. Complete the form and we'll confirm receipt and next steps within two business days.

We Accept Referrals For

We welcome referrals for the following services:

Men's Behaviour Change Program (Melbourne, in-person)
Men's Behaviour Change Program (Online)
Addiction (AOD) Counselling
Anxiety Counselling
Depression Counselling
Life Direction Counselling
Sex Therapy Counselling
General Counselling Services

Submit a Referral

For urgent referrals, please book a consult or email Alex directly rather than waiting on this form.

First Name*

Last Name*

Organisation / Practice Name*

Your role

Phone number

Email*

Client's First Name*

Client's Last Name*

Client's Age

Client's Phone

Client's Email

Service You Are Referring

Men's Behaviour Change Program (Melbourne)

Men's Behaviour Change Program (Online)

Addiction (AOD) Counselling

Anxiety Counselling

Depression Counselling

Life Direction Counselling

Sex Therapy Counselling

General Counselling Services

Reason for Referral / Relevant Background

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All information shared through this form is treated as confidential and used solely to coordinate care for your client. Please avoid including sensitive clinical details here — general context is sufficient, and Alex will follow up directly to discuss specifics.