The Australian DBT Institute provides a collegial space for independently contracted mental health practitioners to practice from our three private mental health clinics and through DBT Assist (our National DBT Telehealth Service).

Before commencing with one of our Essentia Health Clinics or DBT Assist, each independently contracting mental health practitioners is required to:

Please complete the below form and attach all required documentation before commencing with Essentia Health Clinics or DBT Assist. Should you seek clarification about the below form please contact our admin team at the Australian DBT Institute via email at info@dbtinstitute.com.au

Personal Information

If you have a seperate number for clients to contact you please provide this number. We do not expect clinicians to have a seperate number nor do we expect you to have a direct line for clients to contact you. Please state NO PHONE NUMBER TO SHARE if you do not wish to share any phone numbers with individual clients!
We hope we never need to use this. In the case of an emergency our clinical director or executive director will contact your NOK if needed.
Please include your Account Name, Bank, BSB and Account Number

Clinical Practice

Please provide the qualifiction and any abbreviations used when communicating qualifications
Select all populations above that you do not wish to receive referrals for
Select all populations above that you do not wish to receive referrals for

Professional Profile

Click or drag a file to this area to upload.
Please provide a professional looking photo for promotion on our website
Please list the day(s) of the week and times you plan to be working in our clinical services (Essentia and/or DBT Assist)
Limit of 300 words - Please provide a brief summary of your clinical practice and areas of interest.

Supporting Information

Number provided on your certificate of registration
Click or drag files to this area to upload. You can upload up to 3 files.
Click or drag a file to this area to upload.
Please upload your Certificate of Currency for your professional indemnity insurance
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
This agreement needs to be signed and can be downloaded at http://dbtinstitute.com.au/wp-content/uploads/2022/01/Independent-Contractor-Agreement.pdf