Make a referral

Summer Hydrotherapy Sessions

Summer Hydrotherapy sessions are now available! 🤸 Get your child motivated for Physio with refreshing Hydrotherapy sessions! Supported by a qualified Physiotherapist, Hydrotherapy helps your child build muscles and improve mobility - while cooling off in the swimming pool.

Every child. Any challenge.

Referrals

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Kites accepts referrals from parents, carers, family members, allied health professionals, GPs and other specialists.

To get started with your referral to Kites therapy, please fill in our easy online referral form below. If you have information about your child or patient’s diagnosis or medical history, keep it handy to supply with your application.

Don’t like filling in forms? No worries! Call us on 9311 8222 and we’ll take care of everything you need to get you started on your Kites journey today.

Therapy for Children & Youth Referral Form

Details of child

Address
Address
Suburb
State
Postcode
Australian Residency Status *

Details of parents(s) / guardian(s)

Is this person the child's legal guardian?
Parent/guardian 1 address *
Address
Address
Suburb
State
Postcode
Country
Is this person the child's legal guardian?
Parent/guardian 2 address
Address
Address
Suburb
State
Postcode

Details of referral: explain what goals you are wanting to achieve.

Please attach copies of diagnostic reports (if available)

Maximum file size: 10MB

Attach up to three PDF or Word documents. Maximum upload size is 10 Mb.

Swallowing/Choking (Dysphagia)

Are there any difficulties with swallowing (dysphagia), such as choking, coughing, or feeling like food is stuck in the child's throat?

Positive Behaviour Support

Are there any Positive Behavioural Support (PBS) plans currently in place for the child?

Maximum file size: 5MB

Does your child engage in any behaviours that may compromise the safety of our therapy dog?
Preferred times for services

Maximum file size: 5MB

Contact details for referee

Complete this section only if the referee is not the parent
Declaration *

Privacy Collection Notice

EverAbility Group Ltd is collecting your personal information so we can respond to your enquiry. You can read more about how we deal with your personal information in our Privacy, Dignity and Confidentiality Policy which you can access via the EverAbility website.