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AppointmentSam Nassar2021-01-10T10:57:19+00:00

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Name of Carer/Parents *

First

Last

Primary Contact Number *

Email Address *

Reason for Seeing Paediatrician? *

Behavioural: ADHD and other challenging behaviours
Developmental: Autism Spectrum Disorder, Developmental delay including speech
Learning Difficulties
Newborns and Infants conditions
Asthma and Chronic cough
Allergy and Eczema
Constipation and Abdominal pain
Bedwetting and Daytime wetting
Skin Rashes
Seizures and Movements disorders
Sleep Disorder
Weight Management
Intoeing & Other Musculoskeletal Problems
Other

Name of Child *

First

Last

Date of Birth(Child) *

Referral Provider/GP Name *

About Kids Clinic

Kids Clinic is a Paediatric Clinic and Early Intervention providers (NDIS) for children with developmental, behavioural and functional skills impairment.

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192 Northam Ave, Bankstown, NSW 2200
02 8404 0567
info@kids-clinic.com.au
02 8456 6098

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