Ages & Stages Screening
Please complete the registration form to be contacted by Eloise from ODEEP. Screening will occur during or after selected playgroup sessions. ** Please note you must attend at least one playgroup session with Playful Discoveries Blayney to be eligible so that we can get to know your child before their screening
Name
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
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Child’s Name
Child’s Age
Reason For Screening
I have a particular current concern
Just seeking an overall picture of where my child is at across developmental areas
Optional: Details of current developmental concern
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Do you regularly attend Playful Discoveries Playgroup?
Yes
I have been once before
No
I would like more info about playgroup
How did you hear about this opportunity?
Submit
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