Swimming Form

Before we can confirm your place in the swimming program we need to review this information: For more information email tasha@greenhousepaediatrics.com.au

Child Name(Required)

Name Last

Child Age

Has your child attended swimming lessons in the past?

Yes

If Yes, what is your child's current swimming level?

Does your child follow instructions in group situations?

Has your child attended any groups in the past?

How does your child communicate?

Has your child had previous Occupational Therapy or Speech Therapy?

What do you hope to gain from your child's attendance to Swim Group?

Parent Name(Required)

Name Last

Contact Number(Required)

Email(Required)

Funding

NDIS Plan Managed

NDIS Self-Managed

Private Insurance

Other

Swimming Form

Swimming Form

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Company

Allied Health

Medical Health