Trans Health SA Practitioner Listing Request

Requester

These details are used if THSA needs to clarify the request.

Your name

Your email

Practitioner Details

These details are used to assess and prepare the public directory listing.

Practitioner name

Practice name

Specialisation

Phone

Practitioner/admin email

Public email

Website

Region

Practice address

Listing Information

This content helps THSA assess suitability and prepare the listing text.

Why would you like this practitioner listed? Include relevant gender-diverse, trans, non-binary, LGBTIQ+, or gender-affirming care context.

Public listing blurb Write the public-facing description that could appear in the directory.

Applicable options

GP referral may be required Open to under 18 patients Open to over 18 patients Open to Youth Under 25 Low/no/NDIS cost options Family Space Telehealth available

Confirmation

I confirm these details are accurate to the best of my knowledge.

I understand THSA may use this information to assess the request and prepare a public directory listing.

Pre-submission Check

Run a quick AI check before submitting. Issues reported here are not hard blocks, but they may prevent approval or lead THSA to ask for more information.