Send a request to be added to the waitlist

Team members are in the office from 8 am to 4 pm, Monday to Friday.
Please enter your details below to submit a request.

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Email Address: *

Phone Number: *

Client First Name *

Client Last Name *

Date of Birth *

What do you require support with? *

Unfortunately, our waitlist for Speech Therapy is currently closed.

Please indicate if you are happy to receive automatic text messages and emails related to your inquiries *

If you do not wish to receive automatic text messages or emails, please contact our office directly at 3819 0282.

Comments:

We will be in touch with you as soon as possible to provide you with further information.