Group Therapy Enquiry
Client/Child Full Name
Please provide your full name
Email
You must provide an email address
Phone
This field is required
Date of Birth
Please describe current communication difficulties, including any diagnoses:
Other information
This field is required
NDIS number (if applicable)
Please select NDIS plan management details:
Plan managed/3rd party managed NDIS funds
Plan manager:
Self managed NDIS funds
NDIA managed NDIS funds (please note we are unable to see NDIA-managed participants)
Private client
Please select groups you are interested in attending:
Social collaborative gaming - teen (Monday afternoon)
Teen social (Monday afternoon)
Lower/Mid Primary Cook and Create (Tuesday afternoon)
Mid/Upper Primary Cook and Create (Tuesday afternoon)
Year 4 - 7 girl social (Wednesday afternoon)
Minecraft - primary school (Monday or Thursday afternoons)
Playgroup (Thursday 10:15am - 11:15am)
I am not a robot is required
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