Below are forms that need to be completed prior to attending
your first appointment with one of our staff.
Please contact the office (08) 9450 6939 if you have any difficulty downloading the form.
Please contact the office (08) 9450 6939 should you have any difficulty in completing the form
Please click on the picture below to open our Client Information Form or “Right Click” and select “Save Target As” to download it to your computer.
Client Information Form (873 KB)
Kathy Ziatas Speech Pathology is a panel member through the Department of Families, Housing, Community Services and Indigenous Affairs (FaCHSIA) to provide services through the Helping Children with Autism and the Better Start Early Intuitive
The attached forms are required to be completed before treatment can be started. If you are about to attend one of our offices for support through Helping Children with Autism and the Better Start Early Intuitive then please download and complete the forms for your first appointment. If you are unable to do so then please advise your Therapist when you attend the office and they will assist you.