Want to see an orthotist for AFOs?

Leave your details and we'll be in touch.

Client's First Name *

Client's Last Name *

Are you the client?

YesNo

Your First Name *

Your Last Name *

Relationship to client

Email Address *

Phone Number *

Which state would you like to receive your orthotic services in? *

NSWQLD

What would you like to do?

Book an appointmentDiscuss my situationSomething else (please detail below)

BOOK AN APPOINTMENT

Where would you like to book an appointment? *

NSW - NAPA Sydney Clinic, Lane Cove (Tuesdays weekly)NSW - Cerebral Palsy Alliance, Kingswood (Fridays weekly)NSW - Cerebral Palsy Alliance, Dubbo (Tuesdays monthly)QLD - AbilityMade Queensland Clinic, Beerwah (Mon-Wed weekly)QLD - NAPA Brisbane Clinic, Shailer Park (Tuesdays monthly)QLD - Leaps and Bounds Disability Services, Caboolture (Wednesdays fortnightly)QLD - Enhanced Living, Maroochydore (Tuesdays monthly)

Select one or more locations that could work for you

Briefly tell us about your AFO needs *What are you looking for and why? Worn AFOs before? What were they? What worked/didn't?

Current Funding *Please note that we do not currently see NDIS Agency Managed participants.

Do you have 3-4 hours of capacity building for initial assessment and report writing?

Do you currently see a physio, OT or other therapist we can get a clinical referral from? *

YesNo

Therapist's Name *

Therapist's Role *eg. Physio, Exercise Physiologist, OT

Therapist's Email *

Therapist's Centre Nameeg. Physio, Exercise Physiologist, OT

Any preferred days?

MondayTuesdayWednesday

We'll do our best to work to your preferred days/times

Any preferred times?

Early (8am)MorningAfternoon

DISCUSS MY SITUATION

What would you like to discuss?Please provide more context so we can direct you to the right person. (eg. Is it a clinical, funding or logistical discussion?)

Anything else you'd like us to know?

We will be in touch with you as soon as possible to confirm your appointment.