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Reason for Enquiry    NDISAged CareMedicareDVATeleHealthWorkcoverInformation OnlyHomecarePrivate clientOther

Primary health concern –None–UnknownBlindDeafDeafblind (dual disability)HearingLanguage DisorderMild Hearing LossModerate Hearing LossProfound Hearing LossSpeechVisionVision ImpairedVisionTHI – PedestrianAcquired Brain InjuryAdjustment DisorderADHDAutismAlcohol RelatedAlzheimers DiseaseAmputationAnkylosing SpondylitisAnoxia/HypoxiaAnxietyAphrasiaArthrogryposisAsperger SyndromeAtaxiaAutismBack InjuryBehavioural DisorderBi Polar affective DisorderCerebellar DegenerationCerebral LeukodystrophyCerebral PalsyCervical SpondylitisCharcot-Marie-Tooth DiseaseChildhood Apraxia of Speech (CAS)Conduct DisorderCongenital DeformityCVADementiaDepressionDevelopmental delay 0-5 yrs onlyDown SyndromeDysphasiaDyspraxiaDystoniaEating DisorderEpilepsyExpressive DisorderFamilial Spastic ParesisFriedreichs AtaxiaGlobal Developmental DelayGuillain Barre SyndromeHigher Functioning AutismHIV – related Brain InjuryHomocystinuriaHuntington’s DiseaseHyperopia (Long Sighted)Impulse Control DisorderInfectionIntellectualLanguage DisorderLiteracyMixed Receptive/Exp DisorderMotor Neurone DiseaseMultiple SclerosisMulti System AtrophyMuscular AtrophyMuscular DystrophyMyasthenia GravisMyopia (Short Sighted)NeurofibromatosisNeurologicalNeuropathyNystagmusObsessive Compulsive DisorderOppositional Defiance DisorderOsteo ArthritisOsteogenesis ImperfectaOther Brain InjuryOther NeurologicalOther PhysicalOther PsychiatricParkinsons DiseasePersonality DisorderPervasive Developmental DisorderPhysicalPolymyositisPost Polio SyndromePost Traumatic Stress DisorderPsychiatricReceptive Language DisorderRheumatoid ArthritisScheuermann’s DiseaseSchizophreniaScoliosisSemantic/Pragmatic DisorderSensory Processing Disorder/ Emotional RegulationSleep DisorderSpecific Learning Disability / ADDSpeechSpeech Delay / DisorderSpina BifidaSpinal Cord InjurySpinal Cord StenosisSpinocerebellar DegenerationStrabismusStutteringSubstance AbuseSyringomyeliaTHI – AssaultTHI – Home/Recreation AccidentTHI – MVATHI – OtherTHI – PedestrianTHI – Work AccidentTumour

Secondary health concern –None–UnknownBlindDeafDeafblind (dual disability)HearingLanguage DisorderMild Hearing LossModerate Hearing LossProfound Hearing LossSpeechVisionVision ImpairedVisionTHI – PedestrianAcquired Brain InjuryAdjustment DisorderADHDAutismAlcohol RelatedAlzheimers DiseaseAmputationAnkylosing SpondylitisAnoxia/HypoxiaAnxietyAphrasiaArthrogryposisAsperger SyndromeAtaxiaAutismBack InjuryBehavioural DisorderBi Polar affective DisorderCerebellar DegenerationCerebral LeukodystrophyCerebral PalsyCervical SpondylitisCharcot-Marie-Tooth DiseaseChildhood Apraxia of Speech (CAS)Conduct DisorderCongenital DeformityCVADementiaDepressionDevelopmental delay 0-5 yrs onlyDown SyndromeDysphasiaDyspraxiaDystoniaEating DisorderEpilepsyExpressive DisorderFamilial Spastic ParesisFriedreichs AtaxiaGlobal Developmental DelayGuillain Barre SyndromeHigher Functioning AutismHIV – related Brain InjuryHomocystinuriaHuntington’s DiseaseHyperopia (Long Sighted)Impulse Control DisorderInfectionIntellectualLanguage DisorderLiteracyMixed Receptive/Exp DisorderMotor Neurone DiseaseMultiple SclerosisMulti System AtrophyMuscular AtrophyMuscular DystrophyMyasthenia GravisMyopia (Short Sighted)NeurofibromatosisNeurologicalNeuropathyNystagmusObsessive Compulsive DisorderOppositional Defiance DisorderOsteo ArthritisOsteogenesis ImperfectaOther Brain InjuryOther NeurologicalOther PhysicalOther PsychiatricParkinsons DiseasePersonality DisorderPervasive Developmental DisorderPhysicalPolymyositisPost Polio SyndromePost Traumatic Stress DisorderPsychiatricReceptive Language DisorderRheumatoid ArthritisScheuermann’s DiseaseSchizophreniaScoliosisSemantic/Pragmatic DisorderSensory Processing Disorder/ Emotional RegulationSleep DisorderSpecific Learning Disability / ADDSpeechSpeech Delay / DisorderSpina BifidaSpinal Cord InjurySpinal Cord StenosisSpinocerebellar DegenerationStrabismusStutteringSubstance AbuseSyringomyeliaTHI – AssaultTHI – Home/Recreation AccidentTHI – MVATHI – OtherTHI – PedestrianTHI – Work AccidentTumour

Requested Service – Hold ctrl to select more than one   DieteticsExercise PhysiologyHomecareTeleHealthTeleConnectOccupational TherapyPhysiotherapyPodiatryPositive Behaviour SupportPsychologySpeech PathologyOther

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