New Clients Enquiry Form

Have you been searching for an Occupational Therapy service that can meet the needs of your child?

Contact us to begin the intake process.

New Client Enquiry

Please complete this form so we can better understand your requirements and arrange a booking for you.
  • Please fill in your name so we know how to address you.
  • We don't need your child's birthday yet, but it helps us if we know what age group your child is in.
  • Please select the reason/s you believe your child requires Occupational Therapy. (For more information about each of these areas, please have a look at our Services Page.)
  • It would be great if you could give us a brief outline about your child and what sort of service you think they require.
  • Please provide us with your phone number and email so that we can contact you.
  • Please provide an email address so that we can contact you if we are unable to reach you on the phone.
  • Please let us know what suburb you live in.
  • Please let us know which of our three locations you would prefer to attend.
  • Is there anything you would like to ask us about, or any further information you would like to offer?
  • This field is for validation purposes and should be left unchanged.