During the January school holidays Qualia will be offering blocks of 4 x 40 minute intensive therapy sessions, across 1 or 2 weeks. If this is something you feel your child may benefit from, please indicate availability.
start
 
Your name

 
Your child's name

 
Please indicate your availability during the January Holidays:

Please note: this is for planning purposes only, not a confirmed time. You can select as many options as you like. The more flexible you can be, there more likely we will be able to offer you sessions!

 
Where would you prefer {{answer_iyfFAwzmxegS}}'s sessions take place?

Please note: the more flexible you can be, there more likely we will be able to offer you sessions!

 
What are your main goals for {{answer_iyfFAwzmxegS}} in attending these sessions?

 
Mobile

 
Email

Thanks for completing this typeform
Now create your own — it's free, easy, & beautiful
Create a <strong>typeform</strong>
Powered by Typeform