Children's Groups - Expressions of Interest - Psychologists Loganholme & Capalaba

Which group would you like to register for? *

Socially Speaking (4 to 7 yrs olds)Club Cool Connections / Stress Reduction (ages 7 to 9)Sensory Processing (5 to 7 yrs old)Sensory Processing (8 to 10 yrs old)Say No to Bullying (10 to 15 yrs old)Animal Assisted Therapy Group for Disengaged Teens (ages 13 to 17)

Which location would you like to attend? *

LoganholmeCapalaba

Previous Counselling with The Psych Professionals

Is your child/teenager a current or previous client of our practice?CurrentPreviousNo

Previous Counselling

Has your child/teenager attended counselling with a Psychologist during the last 6 months?YesNo

Diagnosis, Concerns, Challenging Behaviour or Presenting Problem: If your child/teenager has received a mental health diagnosis from either your GP/Paediatrician/Psychiatrist/Psychologist, please specific such.

Health Care Card *

Do you have a current Health Care Card?YesNo

Questions or Comments

If you have any additional Questions for us or would like to make any Comments not covered by this form, please list such.

Kids Groups – Expressions of Interest

Details of Young Person

Group Details

Verification

Loganholme Practice

Cleveland Practice