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SociAble Kids and Teens: Growing Calm, Capable and Confident Young People

Registration
This form is to express your interest in having your child or young person participate in a SociAble Kids or Teens group with Inspired Psychology.

Please note that registration is not confirmed until payment of fees is received.

Program Dates
All program dates are set once we receive a minimum number of applications. Times and days are negotiated with registered participants prior to confirming a start date. 
Child's Name *
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Child's DOB *
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Preferred Age Group- Please note the overlap in ages for groups exists to allow for participants to be placed in the appropriate group for their level of development.
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Preferred Location (more than one can be selected) *
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Availability (please mark all that apply) *
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Parent/Guardian Name *
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Mobile number *
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Email *
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Please enter a valid e-mail address.
Address *
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How did you hear about our SociAble Kids/Teens programs? *
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Referrer details (if referred by GP or other professional)
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Are there other professionals involved (e.g OT,Speech Pathologist etc)?
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What are your main concerns regarding your child's social skills? *
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What are your main concerns regarding your child's ability to manage emotions? *
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What are you hoping your child will get out of the program? *
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FEE ARRANGEMENTS

Fees for SociAble Kids/Teens programs to June 30 2019 are $91.66 per session (9 sessions in total).

All aspects of the program are included in this fee including a clinical evaluation of participant needs prior to the program starting, measures to track progress and outcomes, parent feedback via email, a 1:1 parent coaching session with one of the psychologist facilitators, all resources across the program, a family resource package and all program sessions including the booster session.

Fees are charged for the program as a whole and on the assumption that all sessions will be attended. Missed or cancelled sessions do not attract a refund.

We require payment to be made in full a week prior to sessions commencing. In special circumstances we offer a flexible payment plan.

We offer a reduced fee program for eligible participants. They must have a valid concession card and be referred by their GP for group therapy under the Better Access Scheme.

Please note that all participant families are ultimately responsible for payment of fees.

CANCELLATIONS
We offer a full refund for cancellations received up to 7 days prior to the program starting. All cancellations between 0-7 days will attract a $150 cancellation fee. No refund is available once the group sessions have commenced.
How will you be paying for the program? *
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Will you be paying in full prior to the program starting? Medicare and private participants only.
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Do you believe you are eligible for the low fee program? Must have valid concession and be referred by GP for group therapy under Better Access.
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Any questions or comments?
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Our practice manager Zoe will be in contact shortly to discuss program start dates and to finalise details. We look forward to having your child or young person participate in our SociAble Kids or Teens program.
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