Therapy Pro Group Sessions

Please complete this questionnaire to participate in a Therapy Pro group session. If you are an NDIS participant, once this form has been received by our team, a Service Agreement will be prepared and sent to you to sign to confirm your place. If you are a fee for service participant, once this form has been received by our team, an invoice will be sent to you to confirm your place.

Participant name*

First Last

Participant's date of birth*

DD

MM

YYYY

Your name, if not the participant

First Last

Best contact phone number*

Best contact email address*

Presenting difficulties:

Please tick the box if yes

Select All
Does the participant have adequate understanding and use of words/language to engage in conversations?
Is the participant an independent communicator (does not rely on support worker/parent)?
Does the participant have basic literacy skills?
Does the participant have access to Zoom via a tablet/laptop/desktop?

Does the participant have difficulty with any of the following social skills:

Please tick the box if yes

Please place any additional explanatory comments here that will help our facilitators place the participant in the most suitable group session.

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Group Sessions Questionnaire

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