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
Rebecca Cresswell
Samantha Miles
Ynna Acosta
Rebecca Gatt
Rebecca Middeldorp
Ellena Batsakis
Lisa Mamo
Valerie Graham
Rosemary Fleming
Sarah Wilby
Wendy Stanborough