0408 622055


Application for Assistance

Our priority is to assist families who might otherwise struggle to afford essential aids and equipment.

Please ensure all questions are answered and relevant documentation is attached.

You will need a current quote for the aids or equipment sought as well as a supporting medical report from a
General Practitioner, Specialist, Physiotherapist or Occupational Therapist (not more than 12 months old)
that details the Child’s physical disability.

Photographs of the Child trialling the equipment or aids will also assist.

Applications may be submitted by the child’s Parent / Carer or Therapist.

1Child's Details
2Parent(s) / Carer(s) Details
3Referrer Details
4Equipment / Funding Details

Child's Details