Contact us Contact us Contact us Parent Name * First Name Last Name Parent Email * Parent Phone Number (###) ### #### Child Name First Name Last Name Child Date of Birth MM DD YYYY What days/times would you prefer for therapy Message * Checkbox Play Therapy Art Therapy Lego Therapy Counselling Group Work Animal Assisted Play Therapy Psycho-social Occupational Therapy Paediatric Occupational Therapy Parenting Support Other Thank you!