Contact Ecdysis Psychiatry

Get in touch

For all referrals and clinical inquiries please use the referral forms. For other inquiries please contact us at info@ecdysis.co.nz

Dr G only sees adults age 18 and over.

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Full Name

Date of Birth

Address

Phone Number

GP Name

GP Practice

GP Phone Number

What psychiatric services are you seeking?

Do you have a therapist?

Ecdysis does a limited number of ADHD assessments each month. These assessments are first come first served and provide both assessment and treatment (if the diagnosis is made or confirmed). Feel free to contact us regarding the current wait time for an ADHD assessment.

Therapist Details

Therapist Name

Phone Number

Please list psychiatric conditions (if any)

Please list medical conditions (if any)

Other information

Dr G only sees adults age 18 and over.

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Patient’s Name

Patient’s NHI Number

Patient’s Date of Birth

Patient’s Address

Patient’s Phone Number

Patient’s Email

Patient’s Preferred contact method

Your name (GP or referring provider)

GP Practice (or referring practice name)

GP Phone Number

What psychiatric services are you seeking for your patient?

Does your patient have a therapist?

Therapist Details

Therapist Name

Please list any known psychiatric conditions for your patient (if any):

Please list any known medical conditions for your patient (if any):

Other information

Do you wish to speak with the psychiatrist regarding your patient?

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