LEAP Appointment Request

Request a confidential
Leaders and Executives Assistance (LEAP) counselling appointment

The Leaders and Executives Assistance Program is a completely confidential service dedicated to senior leaders and executives.

You can begin the registration process by completing the form below, or by calling LEAP hotline on 1800 986 865.

Through the LEAP service, you have access to Assure’s most experienced Psychologists.    Before starting the online registration process, please view the profiles of our LEAP specialist Psychologists, to select which one is best suited to your needs.

Once you have reviewed and selected which of our Psychologists best meets your needs, please complete the registration form below.  One of our Triage Psychologists will then make contact with you to complete the registration process and connect you with your selected Psychologist.

The details you enter below will only be used to commence the registration process and book your counselling session. Once you have submitted your request, we will call you within 1 business day to finalise your registration and confirm your session booking details.

If you require urgent counselling assistance, please call Assure Programs on 1800 808 374
If you require emergency assistance, please call 000

Date of Birth*
(Required for identity verification when confirming the appointment)

Choose an Appointment Location*

What days/times are you available?*
First Choice
Second Choice
Which Psychologist would you like to engage with?*
First Choice
Second Choice