Dear Parent, at Kool KATTS we will endeavor to have your child booked in with us as soon as we possibly can. Please complete the below form so that we can contact you with the next steps.
Child's date of birth
Street Address Line 2
State / Province
Postal / Zip Code
Are you interested in the SENSE RUGBY group only?
Are you available for urgent assessments in case of last minute cancellations
Would you be interested in Telehealth services?
What are your main concerns for your child?
Is your child speaking/non speaking?
Does your child have a diagnosis? If so, please provide more detail.
Does your child have any medical conditions?
What days are you available?
What are your preferred times?
Does your child have NDIS funding?
Self managed NDIS
Plan managed NDIS
NDIA managed (funding is held by NDIS)
Awaiting NDIS funding
What school does your child attend? Are they in a mainstream or support class?
What are your goals for therapy
How did you hear about us?
Our after school appointments are generally offered first to current clients. If your child is at school would you be interested in an appointment time during school hours and offered an after school time asap.
Yes, we need therapy asap
No we can only make after school
Office Use Only
Should be Empty: