Parent Inquiry Form

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Parent Support Inquiry Form

Let’s start with a few quick questions.

This helps me understand your needs and offer the right support.

It only takes a few minutes.

First Name *

Last Name

Email *

Which age range(s) are your children? (Please tick all that apply)

0-5

5-12

13-18

What kind of support are you seeking?

Understanding my child’s needs

Support with emotional regulation or meltdowns

Support for managing my own overwhelm and nervous system

Communicating with school or health professionals

Preparing for or navigating school meetings

Support around PDA (Pathological Demand Avoidance)

Identifying and planning support needs (therapeutic planning)

Care team collaboration (e.g. working alongside other professionals)

Recommendations for school or educational planning

I'm not sure yet

To share more detail about what you’re needing support with, or anything else that feels important for me to know right now. (Optional)

Have you had a chance to look at my services for parents?

Yes
Not yet
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Which professionals are currently involved in your child’s care or support team? (Tick all that apply)

Occupational Therapist

Physiotherapist

Speech Pathologist

Social Worker

Art/Music Therapist

Equine Assisted Therapist

Psychologist

Paediatrician

Other (please specify)

If you selected 'other' please specify other supports

What funding source would you use for sessions?

NDIS Self-Managed

NDIS Plan-Managed

Private Paying

I'm not sure yet

Would you like to book a free 20-minute discovery call?

Yes
Not at this stage
I'd prefer to book a full appointment
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Is there anything you’d like to ask or share before we speak? (Optional)

I consent to receiving communications and I understand I can opt out at any time.

Thank you for sharing, I really appreciate you taking the time.

I’ll be in touch soon and look forward to connecting.

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