New Client Appointment Requests

If you would like to make a booking, please fill in the form below. Our team will process your application and be in touch within the week.

Your name (person completing the form)

First Name

Last Name

Your relationship to the child:

Contact phone number

(###)

###

####

Email address

Preferred method of contact

Do you require an interpreter?

Child's name

First Name

Last Name

Child's age

Child's gender

Child's address

Has the child had an assessment already?

For example: paediatrician, hearing, vision, occupational therapy, psychology, speech pathology Please describe where and when.

Reason for referral

Please describe your main concern about your child's communication

Are any other languages spoken from home?

Are you looking for home or school visits for the child?

We are a predominantly clinic-based service in Caroline Springs and currently are *not* taking on new referrals for regular school and/or home visits.

Are you looking specifically looking for afterschool appointments for the child?

We generally offer sessions between 9am and 5.30pm on weekdays. Due to the large volume of school aged children that we see we have a longer wait times for after school sessions. Could you make yourself available between 9 and 3 for an appointment?

Funding options

As a private clinic, we are a fee for service. Does your child have any funding? e.g. Medicare Care Plan, NDIS, private health. Please note, we do not see NDIA-managed clients.

What school/daycare/kinder does the child attend?

What grade/class are they in this year?