Free Clinics / Gala Days / Roadshows
Please fill out the information below and your State/Territory representative will be in contact about running a Free Clinic/Gala Day where possible:
Clinic Information
Teacher Name
*
First Name
Last Name
School Name
*
example@example.com
Please select what State or Territory you are from:
*
Please Select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
What Year Groups would you like to run a Free Clinic / Gala Day for:
*
Whole School: Prep-Year 6
Prep
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
High School
Other
What Term would you like to run a Free Clinic / Gala Day in:
*
Term 1
Term 2
Term 3
Term 4
Email
*
example@example.com
School Postcode
*
Example: 3000
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Submit
Should be Empty: