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Wondering if therapy would benefit your child?

Please fill in this form below and your child will be added to our waiting list. One of our team will be in contact as soon as an appointment time becomes available and an initial assessment can be arranged.

Therapy Enquiry

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Child's name *

First and Last Name

Child's date of birth *

We provide services to children 0-18 years of age

Child's gender *MaleFemaleOther

Child's address *

Street Address, Suburb and Postcode

Preferred Clinic Location *Allambie HeightsWarriewoodNo Preference

Child's cultural background

Languages spoken at home

Child's confirmed or suspected diagnosis *

Child's school

School grade/year *PreschoolKindergartenYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12

Parent's name *

First and Last Name

Parent's contact number *

Email *

Please describe or list what you are hoping to work on in occupational therapy

Which areas of your child’s development concerns you? *

• Fine motor skills, such as handwriting, drawing, managing scissors, cutlery, shoelaces and buttons
• Movement and balance: lacking confidence when moving and may look clumsy, bumps into things, falls more frequently than peers
• Gross motor skills: running, jumping, catching a ball, learning new movements or sports
• Organisational skills: maintaining attention, sequencing tasks, remembering and looking after belongings, time management
• Sensory processing: over or under sensitive to touch, sound or movement; can’t seem to sit still, easily distracted
• Meal times: fussy or avoids new foods or smells
• Social skills: making friends, playing with peers, taking turns, reading play or conversation
• Emotional regulation: easily frustrated, regular meltdowns, anxiety
• Self care skills: feeding self, toileting, showering or bath time, brushing teeth or hair
• Daily routine, including sleep patterns, attending school, enjoying community activities or going to the shops
• Not applicable

What are your child's strengths?

Which days or times would fit best with your family's schedule? *

• Monday before school
• Monday middle of day
• Monday after school
• Tuesday before school
• Tuesday middle of day
• Tuesday after school
• Wednesday before school
• Wednesday middle of day
• Wednesday after school
• Thursday before school
• Thursday middle of day
• Thursday after school
• Friday before school
• Friday middle of day
• Friday after school

Please note outside school time appointments are reserved for school aged children

What funding pathway are you wanting to use for OT? *

• Private payment
• Self managed NDIS
• Plan managed NDIS
• Waiting for NDIS funding

How did you find out about Kids Plan-it?

• Digital (Google or other search, website)
• Social media (Facebook or Instagram)
• Word of mouth
• Referral from a friend, family or colleague
• Referral from another professional, such as NDIS, paediatrician or your GP
• Referral from a school or early childhood centre

Send Enquiry