Free Kids Health and Developmental Screenings

Which location would you like to visit?*

Bowraville (Bowraville HealthOne) Tuesday 13 SeptemberNambucca Heads (Nambucca Heads HealthOne) Wednesday 14 SeptemberNambucca Heads (Nambucca Heads HealthOne) Thursday 15 SeptemberTumbarumba (location TBC) Tuesday 25 OctoberTumut (location TBC) Wednesday 26 OctoberTumut (location TBC) Thursday 27 October

Select preferred time*

Child's Full Name*

Child's DOB (DD/MM/YYYY)*

Gender*

Has the child ever been to Royal Far West?*

Does your child have an NDIS package?*

Is your child currently accessing and/or on a waitlist for any local services? If so please identify which one*

Guardian's Name*

Postal address*

Town*

Postcode*

Home phone

Mobile phone*

Email*

Medicare Number*

Medicare Card expiry date*

What is your (parent/carer) vaccination status?*

Double vaccinatedSingle vaccinated (awaiting second)Not vaccinated

Child's reference number on Medicare Card*

What preschool/school does your child currently attend?*

What preschool/school will your child be attending next year?*

Who is your child's GP?*

GP Address*

Who is your child's dentist?*

Has your child been to see a dentist in the last 12 months?*

Is your child's immunisation status up to date?*

Is your child of Aboriginal or Torres Strait Islander origin?*

How did you hear about the Health and Developmental Screening?*

Who will be attending the Screening with the child?*

Does your child have motor skills development difficulties (e.g. handwriting, using scissors, throwing/catching a ball etc.)?*

Does your child have difficulties with speech or language? *

When was your child's last hearing test?*

What was the result of the hearing test?*

When was your child's last vision test?*

What was the result of the vision test?*

Do you have any concerns about your child's emotional wellbeing?*

Comments

Does your child have any significant behavioural difficulties?*

Comments

Does your child struggle to pay attention?*

Comments

Do you have any other concerns regarding your child?

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Healthy Kids Bus Stop

Healthy Kids Bus Stop is a free comprehensive health screening program aimed at children 3-5 years of age, run in partnership with local communities.

Healthy Kids Bus Stop – upcoming visits