NAPA UK Report Request Form

Report Request Form

To assist us with preparing your report, please answer all the below questions adding as much information as you think will assist in your child's planning process. Please note that reports will not be started without the completion of this form. Once you have submitted this form, your report process will begin and you will be liable for the report preparation and writing costs.

We recommend allowing around 30 minutes to complete this form. You do have the ability to save your progress in the form but will need to create an account in order to do this.

For FAQ's, pricing and further help, please click here.
Child's Name

First NameLast Name
Child's Date of Birth
DD/MM/YY
Child's Current Weight
kgs
Address

Street Address

Postcode

CountyCounty

Country
Parent/Carer's Name

First NameLast Name
Preferred Contact Number

Area CodePhone Number
Email address
Requested Report Completion Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearPLEASE NOTE: Your requested date must be in at least 2 weeks (14 days) time. If you request a date sooner than this deadline, your report will be subject to an additional rush fee of $300. Once we have received your request we will confirm your anticipated completion date back with you as some reports can take some time to schedule.
Report Type

Please click on the report you would like to request
Request for (Select any that apply)
Report to cover (Select any that apply)
Therapy Disciplines to cover (Select all you would like covered by the report).
Clinic your child last attended therapy in?
When was your child's most recent NAPA therapy session?
Please note that if your child has not attended NAPA in the last 12 months, we may be limited in reporting on any recent developmental, therapy, or assistive technology needs.

All About your child
Please provide a short description of your child's current living/home situation and environment?
Include: Who lives at home, general description of the home environment (stairs, access issues)
What are your child's likes, loves and dislikes?
Describe what they can do independently, what they can do but need assistance or support to do, what they'd love to be able to do but currently miss out on because of their disability or lack of assistive technology supports, and what makes them happy and what they really don’t like doing. Consider what motivates your child and what are their personal strengths
How are typical daily activities affected by your child's disability?
Consider the level of assistance your child requires for all personal care needs and daily living tasks eg.help dressing, feeding, drinking, bathing and hygiene, toileting, transfers, communication,entertainment, social, learning, transport, etc. Are they independent with some tasks or do they require some or full assistance?
Provide a snapshot of a typical day in your child's life outside of therapy
Please provide a short description of the equipment your child has to support their gross motor mobility, including specific name (e.g. Grillo Gait Trainer, manually powered wheelchair with lateral trunk support and 2.5cm cushion).
Please provide a short description of the equipment your child has to support their 24hour postural care (e.g. shower chair, Lecky Squiggles+ Standing Frame).
What would you like your child to be able to better participate in or access if provided the opportunity, therapeutic support, or assistive technology?
Does your child regularly access other therapies or activities eg. swimming, frame running, horse riding, sport, music etc.
What is your child’s current school/ education setting. Is your child transitioning in the next 12-months to a day care, school, or post-school setting?
Do you use formal supports, such as support workers, to help with your child’s care needs? Or do you rely on informal or family support?
Provide details including name, amount of time, and whether these are formal/informal supports.
How does your child communicate with you, and can they be understood by other people or are they currently unable to effectively communicate their thoughts and needs?
.
Does your child require feeding support? eg.Cannot self-feed, Blended diets, tube feeding, difficulty swallowing, adaptive cutlery,or other Assistive Technology?
.
Does your child require any continence support?
.
Are there any safety concerns for your child,yourself, any other family members or carers because of your child’s size or behaviours?
.
Any current, increasing, or ongoing medical, health, mental health, pain, or sleep concerns for your child?
.
Any planned surgeries in the next 12 months that will require additional therapy support?
.
Describe the impact the disability has on you andyour family, the positives, and negatives.
Consider the current limitations on activities, community engagement, sibling impact etc), on you as a parent (additional care needs, food prep or washing, missed work opportunities, social life, personal injuries, mental health, relationships), and on siblings and extended family. We do encourage you to prepare a Carer Impact Statement to be submitted in addition to or conjunction with a NAPA report.
Once you have submitted your request, a member of our team will be in contact to confirm receipt and timings.
Should be Empty:

Report Type

All About your child