Appointment Request Appointment Request If you have not received contact from us after 48 hours, please phone (08) 9387 9888 to confirm your appointment details. Appointment Type* GP referral - Preferred pathway General appointment - No referral needed Teletherapy service Location*WembleyCockburnPlease select your preferred location. Not all services are available at all locations. Please note general appointments are not available at our Karratha location.If your patient is eligible for the Medicare subsidy under the GP Chronic Care Management Plan and Team Care Arrangement, please fill in the following forms and submit them to us instead of requesting a general appointment. Steps: Click Here to download the combined referral and care plan forms. Complete the forms and attach a copy in an email. Click Here to pre fill your email. Parent/Guardian Name* First name Surname Email* Phone number*Appointment forMy ChildAdult AppointmentAudiologyFull Hearing AssessmentHearing Aid RelatedOccupational TherapyPre-Employment Hearing AssessmentPsychology & CounsellingSpeech PathologyWork Cover Hearing AssessmentChild's name Child's first name Child's surname Child's date of birth DD slash MM slash YYYY Gender Male Female Appointment regarding*Please select an option:My child's hearingMy child's speech and languageAudiology / Hearing servicesSpeech pathologyOccupational therapyChatterbox Program (Early intervention for children with hearing loss)Outpost Program (School support for children with hearing loss)Talkabout Program (Speech and language)Language Support Groups (Language and literacy)Unsure / OtherAdd more details or comments about your requestHow did you hear about Telethon Speech & Hearing?*Internet SearchGP / Health ProfessionalSocial MediaTVNewspaperFriendEventOther...Please specify how you heard about Telethon Speech & Hearing. CAPTCHA Contact us by Phone Contact us by Email Request an Appointment Help us by Donating