DST School referral form for Physiotherapy

Physiotherapy is aimed at supporting children’s physical development and movement skills. If you have noticed concerns with balance, coordination, strength, or overall mobility, this form enables you to share details about the challenges your child may be facing. Your input will allow our physiotherapy team to assess how we can best assist your child in building strength, achieving physical milestones, and engaging more fully in everyday activities.
Please note, you will be required to include contact details for the parent/guardian before submitting this form (Name, Phone, and Email). You will also be asked to confirm that consent has been obtained for this referral. Please ensure you have this information prior to completing the form.