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2/61 Ocean Keys Boulevard

Clarkson, 6030

08 9304 4528

hello@sotospeaktherapy.com.au

New Referral Information

Please complete the form below to send us your referral information

Child's name

Birthday

Day

Month

Year

Phone

What suburb do you live in?

Parent/Caregiver name

Referrer name and contact details (if different from above)

What made you reach out to us today?

Not talking as much as other children (expressive language)

Difficulty being understood (speech sounds)

Difficulty following instructions (receptive language)

Stuttering (fluency)

Reading and writing difficulties (literacy)

Big emotions, frequent meltdowns, or difficulty coping with change

Sensory sensitivities (noise, clothing, food textures, movement)

Difficulty playing with others or making friends

Handwriting, drawing, cutting, or using utensils

Feeding concerns or very restricted food preferences

Difficulty with self-care skills (dressing, toileting, routines)

School readiness or learning concerns

Other

Please provide any other relevant concerns:

Name of your child's School or Daycare:*

Funding

Private client

Medicare client

NDIS, Self-Managed

NDIS, Plan-Managed

Where would you prefer sessions to take place? (Please note: availability may vary depending on therapist capacity and location.)

Clinic based sessions

School or daycare

Home visits

Telehealth

No preference/happy to discuss

Please upload any relevant reports or documents that may help us better understand your child’s needs (if available).

Location

2/61 Ocean Keys Boulevard

Clarkson, 6030

Contact

08 9304 4528

hello@sotospeaktherapy.com.au

Hours

Monday- Friday 9am-5pm

Saturday-Sunday CLOSED

So to speak acknowledges the Traditional Owners of Country throughout Australia and pay our respects to Elders past and present. So To Speak welcomes all neurotypes, races, ethnicities, genders, bodies, sexualities, relationships, and disability.

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Say hello We can't wait to hear from you!

New Referral Information

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Say hello

We can't wait to hear from you!