Lotus Mind - Contact us-Child-Play Therapy Services

Intake form

Child's Full Name*

Date of Birth *

NDIS number

NDIS Plan start Date and End Date

Primary Carer/Guardian Full Name *

Phone number *

Your Email Address*

Address/postcode *

Education/Care Settings*

Does your child have a NDIS plan? If yes, How's the plan is managed? *

Yes

Self Managed

Plan Managed

Briefly describe the client’s diagnosis, main concerns and strengths.*

Medical History/Allergies to be known

What goals would you like to achieve for your child ?*

Consent *

Collaboration with relevant professionals (school/kinder/allied health)

Sharing of session summaries when appropriate

Service Agreement Acknowledgement (NEW SECTION)

I confirm that I have read and understood the Lotus Mind Play Therapy Service Agreement, including fees, cancellations, privacy, and service delivery terms.

I understand that services are delivered by a Play Therapy Practitioner who is an APTA Affiliate Member, using therapeutic play-based approaches within their professional scope.

I understand that play therapy sessions focus on emotional expression, regulation, and developmental support through play and are not a substitute for medical or clinical psychological services.

Get in touch to explore how play based therapeutic Supports/Key Worker Approach can gently support your child’s emotional wellbeing.

NDIS funded support available.

Please note: not Medicare eligible.

Contact Us

We are dedicated to providing nurturing support through play therapy for children and their families.

Location

Business Hours

Mon-Sat: 8am to 6pm

Clyde/Clyde North/Pakenham/Berwick/Officer/Narre Warren/Gippsland VIC

Contact

+61 416946707

ritu@lotusmind.com.au

Email

ABN

19532935959