Working with you to get the best start!

Thank you for providing answers to these questions. They will help you and your therapist get the most out of your appointment.

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* 1. Parent names

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* 2. Parent email address

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* 3. Child name/s

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* 4. Child date of birth

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* 5. Child DUE date of birth (this allows the team to accurately corrects your child's age)

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* 6. Which therapist would you like to see?

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* 7. Please provide a brief summary of your child’s birth history

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* 8. Please provide a brief summary of your child’s medical history

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* 9. Please list any ongoing medical and developmental concerns for your child

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* 10. Please list the health professionals involved in your child’s care

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* 11. Paediatrician’s details

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* 12. General Practitioner details

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* 13. Do you give your therapist permission to contact the other health professionals listed here (if needed) to discuss your own (Parent Psychology) or your child’s care (Child Development)?

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* 14. Please list the concerns you would like addressed at your appointment

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* 15. Please choose one of the following funding options for your therapy.

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* 16. Any further comments

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