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Fit Kidz Foundation Enquiry Form
Thank you for contacting us. To help us provide you with the right information please tell us a little about yourself and you child by answering the questions below.
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* Indicates required question
Your name
*
Your answer
Your email
*
Your answer
Your best contact number
*
Your answer
Your residential address
*
Your answer
Child's name (First name & Surname)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Gender
*
Female
Male
Prefer not to say
Other:
Has your child been diagnosed with a delay or disability or are you in the process of seeking out an assessment?
*
Your answer
Is your child accessing the NDIS?
Yes
No
Applying
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What services is your child currently accessing?
*
Occupational Therapy
Speech Therapy
Behaviour Support
Physio
Childcare or Preschool
School
Other:
Required
Please tell us more about why your are contacting the Fit Kidz Foundation.
*
Your answer
How did you hear about the Fit Kidz Foundation?
*
Recommendation from a friend
Recommendation from a General Practitioner or Specialist
Recommendation from School or Childcare
Social Media
Google search
Other:
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