• Allied Health Client Application Form

    Allied Health Client Application Form

    Welcome! Thank you for choosing Aligned OT. This form will take approximately 5–10 minutes to complete and helps us understand how we can best support you or your child.

  • STEP 1: Tell us what you're looking for

  • Who will be receiving services?*
  • Which service(s) are you interested in?*
  • What are you looking for?*

  • STEP 2: Client details

  •  -

  • Parent/Guardian Details (Paediatric clients only)

  • STEP 3: Tell Us About the Client

  • What are your main concerns?*
  • How does the client communicate?*

  • STEP 4: Service Information

    • Occupational Therapy: Complete this section only if requesting Occupational Therapy 

    • Occupational Therapist (OT):

      • A fully qualified Occupational Therapist registered with AHPRA

      Occupational Therapy Assistant (OTA)

      • Your therapy program is planned by the OT, while the OTA delivers the therapy sessions
      • OTA services are offered at a reduced fee

       

    • Who would you prefer your Occupational Therapy sessions to be delivered by?
    • Which OT services are you interested in?
    • Speech Therapy: Complete this section only if requesting Speech Therapy 
    • What are you hoping Speech Therapy will help with? (Tick all that apply)
    • Dietetics: Complete this section only if requesting Dietetics 
    • What are you hoping Speech Therapy will help with? (Tick all that apply)

  • STEP 5: Funding & Availability

  • How will services be funded?*

  • If applicable:

  • Preferred Appointment Location*
  • Are you interested in?

  • STEP 6: Final Information

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