Book an appointment

Tell us a little about your child and we'll be in touch to arrange a time that suits your family.

Fields marked with * are required.

Child information

Child's first name *

Child's last name *

Date of birth *

Address *

City / Town *

State

Postcode

Contact details

Parent / caregiver full name *

Relationship to child *

Phone number *

Email *

Payment details

Payment details *

Select all that apply.

NDIS - Self ManagedNDIS - Plan ManagedNDIS - Approved (waiting on funding)Privately Funded / Private Health FundPrivately Funded / Medicare GP Care PlanPrivately Funded / Medicare Paediatrician Referral

Physiotherapy needs

Does your child have a diagnosis?

Current concerns *

Physiotherapy goals *

Select all that apply.

Gross Motor SkillsBalance & CoordinationBike RidingPainFatigueSensory IssuesSporting InjuryFracture ManagementLow Muscle ToneToe WalkingHypermobilityNot Crawling/WalkingHead Turning Preference / Flat SpotKnock Knees / Bow LegsFlat FeetEquipment PrescriptionMotor Skills Assessment (only)Sensory Profile Assessment (only)NDIS ReportI am unsure (need support with goal planning)

Session information

Where would you like sessions to be held? *

HomeEarly Childhood CentreSchool (pending approval)

Availability for sessions *

Morning (8:30am - 12:00pm)Afternoon (1:00pm - 3:00pm)After School (3:30pm - 5:00pm) - LIMITEDI am Flexible

Preferred days *

Preferred frequency of therapy *

WeeklyFortnightlyMonthly

Other frequency

How did you hear about PHYSITEK? *

Reports / additional information

Reports and other relevant information

By submitting this form you agree to us contacting you about your enquiry. See our privacy policy.

Prefer to talk?

0412 923 219
admin@physitek.com.au
Monday-Friday, 8:00 am - 5:00 pm
By appointment · Closed on public holidays

Where we work

We're a mobile service covering the greater Brisbane area — therapy in your home, school, early learning setting or community.

Mobile paediatric physiotherapy for children aged 0–18 across Brisbane — in your home, school, early learning setting and community.

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Get in touch

0412 923 219
admin@physitek.com.au
Monday-Friday, 8:00 am - 5:00 pm
By appointment · Closed on public holidays

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