Waitlist Questionnaire for Speech Pathology

  • Waitlist Form for Speech Pathology Services

  • We want to thank you for taking the time to complete our waitlist questionnaire. Your detailed responses are appreciated as it assists us in finding the right services for clients as quickly as we can. 

     

    Please note that HDAH speech pathology services are currently at capacity. You will be added to our waitlist and contacted by email monthly to confirm your continued interest. We cannot guarantee how long it will take for a service to be found in our practice; however, we actively manage our list to ensure that we move as quickly as possible. 


    By filling out this form, you will not be guaranteed an appointment with us. This form helps us find a service to meet your specific needs and manage your position on the waitlist more efficiently. 

    If you no longer require our services, please let us know by contacting us at admin@hdah.com.au.

     

    • Contact & Background Information 
    • Funding Type 
    • Please select the appropriate funding*
    • Reason for engaging with our services 
    • Has your child received speech therapy in the past?*
    • What Speech Pathology services do you require?
    • What Speech Pathology services do you require?
    • Please indicate if the client presents with the following*
    • Client Availability  
    • Rows

    • The more flexible you are, the more easily we will be able to allocate you an appointment time. After school appointments tend to be more desired, therefore more difficult to get in. We reccomend if your child can be seen during school hours, your therapy will be expedited. We cannot guarantee that you get your desired time, as it depends on the availability of our Speech Pathologists.

    • Additional Questions 
    • Would you like to receive emails about waitlist updates and essential emails about Hills District Allied Health*
    • I require a call back: HDAH endeavours to call new clients back within 7 business days.*
    • Where did you hear about us? (Optional)
    • Client Availabilities
    • Should be Empty: