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* 1. What is your child age

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* 2. My child has the ability to work independently and seek assistance when required?

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* 3. Please indicate if your child has one or more than the following diagnosis

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* 4. My child is able to follow more than two-step instructions

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* 5. My child can independently

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* 6. Can your child independently complete tasks with minimal prompting

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* 7. Have access to an electronic device such as an iPad or tablet and use it within sessions? 

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* 8. Can independently navigate with some independence through an electronic device such as an iPad or tablet

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* 9. I consent for Cherished Minds Psychology to contact me and discuss the program. (Please indicate yes or no)

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* 10. Please comment your name, your childs, best contact number and time for one of our friendly psychologists to contact you.

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