Complete the online YAppEE Registration & Agreement Form to access all the support and benefits of YAppEE, including full access to the mobile application and free phone counselling.

Alternatively, you can download and print this YAppEE Referral & Agreement Form, and submit the completed form to yappee@blackswanhealth.com.au.

Once you have submitted the form, one of the YAppEE team will call you to complete your registration and explain how you can get the most out of YAppEE. Upon commencing your new job, they will also provide you with a unique log-in code, which enables you to access the app from your mobile device.

Make sure you check your eligibility here before you register. If you are still unsure of your eligibility, contact us.

Register here:

* Required Field

Full Name*

Date of Birth*

Mobile Phone Number*

Email*

Residential Address*

Postal Code*

Emergency Name & Contact Number*

Do you give YAppEE consent to contact the person above in an emergency?*

What date did you start working in your job (or what is your expected start date)?*

Please provide a brief summary of mental health concerns?*

How did you hear about YAppEE?

PARTICIPANT AGREEMENT

YAppEE is a mobile device app with access to professional telephone support for young job seekers experiencing signs of mental health symptoms or conditions, to assist with staying in employment.
Professional counsellors are available to support you Monday to Friday 8am – 5pm, Australia wide. When the Call Centre is closed and you need support, the YAppEE app recommends other services and organisations. These also include national numbers that operate 24/7.
After joining YAppEE you will have access to support for a minimum of 6-months and a maximum of 12-months.
Please note: YAppEE is not a crisis mental health service and will not replace any other mental health support you may be already receiving. The YAppEE program, through the app or through the call centre, may recommend other services if additional assistance is required.

Use of YAppEE program

I agree to check in with the YAppEE program at least three times per week for the duration of my 6-month service support. I understand, if I do not check in for five days, I will be contacted by YAppEE to establish my wellbeing and determine if I want to continue with the program.
I understand all Information shared between YAppEE call centre staff and myself is confidential and phone calls are not recorded. Information given to YAppEE staff will not be shared with any other services or individual without my specific written consent, except under the following exceptional circumstances;

  • I am at risk of being harmed by someone
  • I am at risk of harming myself
  • I am at risk of harming someone else
  • If they become aware I have committed a major crime which hasn’t been reported
  • They are directed by legislation or a court of law to release information

Purpose of collecting and holding information

I agree to YAppEE collecting and storing my information for purposes of service continuity and measurement of effectiveness of the service provided to me. This may include being contacted for research purposes.
I understand, all written communication may be kept for the duration of the service allowing the counsellor to keep track of interactions and to evaluate the service provision as required.
I understand, the data collected may be used for auditing and quality improvement processes. The information may also be used for accreditation purposes in which case it will be de-identified to ensure privacy and confidentiality.

Consent to this Agreement

I am over 18 and I have read, understand and agree to the above conditions, specified in this Participant Agreement.I am the parent/guardian of the participant and I have read, understand and agree to the above conditions, specified in this Participant Agreement. (Only tick if participant is less than 18 years of age)

Contact information:

Phone: (08) 9201 0044
Fax: (08) 9201 0033
Email: info@blackswanhealth.com.au

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We acknowledge the ongoing support of the State Government of WA, which enables us to deliver this program for free to Perth residents living north of the river.
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