Individual intensives program (CYP Queensland) - Registration form Vision Australia. Blindness and low vision services

Thank you for registering your interest. Please fill in the details below and the service provider will be in contact to arrange your sessions.

Fields marked with an asterisk are mandatory.

Client name*

Parent name*

Email address*

Mobile phone number*

Area of focus:*

Allied health assistant

Speech pathology

Physiotherapy

Occupational therapy

Orientation and mobility

Your child's goal:*

Dates:*

Preferred location*

If you do not see your region available here, we can still offer services via telehealth.

Funding source*

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