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.

Following this request, you will be directed to registration and a developmental form. Both of these forms must be completed for your young person to remain on our waitlist.

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? *

Please select what therapy you will to be added on the waitlist for *

Unfortunately, our waitlist for Occupational Therapy and Speech Therapy for face to face sessions 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.