Primary caregiver *

(if more than one care giver we'll get that information when we follow up)

First Name

Last Name

Participant details *

First Name

Last Name

Date of birth *

MM

DD

YYYY

NDIS Plan end date

MM

DD

YYYY

Assessment Type *

NB: Due to the assessment tool used for sensory assessments, participants must be aged between 3 years and 14 years, 11 months.

Basic Sensory Assessment

Standard Sensory Assessment

Comprehensive Sensory Assessment

Functional Capacity Assessment

Other

Optional Extras

Only available for Standard and Comprehensive Assessments

Equipment prescription – letter of recommendation

‘Sensational Me’. Personalised one-page Sensory Profile overview

Follow up meeting to review the report and discuss findings (recommended for standard and comprehensive assessments)

None