To refer your child for a specific assessment, either call the office on 02 4739 0267 or submit the following form and one of our staff will contact you to complete the referral process.
Child's name:
Child's year at school: Toddler Preschool Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 Other
Child's age: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Other
Child's date of birth: dd/mm/yyyy
Child's school:
Name of parents / guardians:
Home telephone:
Work telephone:
Mobile telephone:
Email:
Postal address:
Type of assessment required: Special provisions for examinations Assistive technology (Computer) Prescription of specialised equipment Funding for equipment and programming Access and environmental modifications Other
What are your child's needs? Your concerns?:
What questions do you want ask us?:
Tel: 02 4739 0267
Fax: 02 4739 9446
Email: info@skillsforkids.com.au
30 Rusden RoadBlaxland NSW 2774
Susan Lowe (Director)
Stephanie Baker
Melinda Conroy
Samantha Miles
Ynna Acosta
Rebecca Middeldorp
Ellena Batsakis
Emma Campbell
Rosemary Fleming