Donate
Pay Invoice
Feedback
Locations
Search
(08) 6282 1900

Home
Us
My goals
Funding
Your Stories
Get involved
Contact

Home
Us
My goals
Funding
Your Stories
Get involved
Contact

Immediate Availability | OT, Physio, Speech Pathology, Children's Continence Clinics

Click For More

Home
Register

Register

What would you like to register for?*
Step 1 of 7
Select a session (SOCIAL SKILLS FUN DAY)*
Child Name*
First Last
Child DOB*
MM slash DD slash YYYY

Parent Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number*

Email Address*

Preferred method of contact*
Preferred contact time
Are you of Aboriginal or Torres Strait Islander origin?

Yes

No

Prefer not to say
Do you have any religious or cultural needs?*

Yes

No
If yes, please comment*

Do you have any Guardianship or Financial Administration Orders in place?*

Yes

No
If yes, please comment*

Are there any other health issues or allergies we need to be aware of?*

Yes

No
If yes, please comment*
Diagnosis*

What does your child hope to gain from this group?
What funding do you receive?*
NDIS - Funds allocated to Rocky Bay
NDIS - Other
WANDIS
Block Funding
Medicare Referral
Privately Funded
Unsure
If NDIS Other, how is your plan managed:*

Self-Managed

Plan Managed
What is your NDIS number?

Plan start and end date:

Do you currently receive services from a Rocky Bay Therapist?*

Yes

No
Did your therapist refer you to this group?*

Yes

No
If yes, which Rocky Bay therapist referred you to this group?

Is your child aged between 7 - 11 years?*

Yes

No
Is a goal relating to social skills and/or making friends covered in your child's plan?*

Yes

No

Unsure
Comment*

Is your child able to participate with minimal support in a group setting?*

Yes

No

Unsure
Comment*
Is your child able to follow complex verbal instructions?*

Yes

No

Unsure
Example - Your child will be able to follow the instruction, "You need to place the green brick on the front left corner of the grey base plate."
Comment

Is your child able to attend to a task with minimal support?*

Yes

No

Unsure
Comment*

Is your child able to regulate their emotions & behaviours?*

Yes

No

Unsure
Comment*

Does your child behave in a safe manner towards others in a group setting?

Yes

No

Unsure
Comment*

Does your child have satisfactory comprehension skills?

Yes

No

Unsure
Example - Your child will be able to follow a complex instruction such as "You need to place the green brick on the front left corner of the grey base plate."
Comment*

Is your child able to explain concepts and deliver instructions to others?*

Yes

No

Unsure
Example - Prepositions and spatial concepts such as: on top, under, next to, front, back, behind, beside, between, rotate, left and right.
Comment*

Does your child require assistance with toileting? If yes, please describe what assistance is needed*

Yes

No

Unsure
Comment*

Does your child have a tendency to become aggressive, anxious or run away?*
If yes, please provide details of any strategies you have in place to manage/reduce these tendencies.
Does your child require any support with communication?*

Yes

No
What type of device does your child have?

Does your child have any physical needs for completing yoga type movements?*

Yes

No

Unsure
Comment*

Is there anything else we need to know before attending the sessions?*
Where did you hear about this event?
Would you like to keep up to date with Rocky Bay news?*

Yes

No
Name
This field is for validation purposes and should be left unchanged.
Δ
Δ
Step 1 of 5
Select a session and date*
Child Name*
First Last
Child DOB
DD slash MM slash YYYY

Parent Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number*

Email Address*

Preferred method of contact*
Preferred contact time
Is the child of Aboriginal or Torres Strait Islander origin?

Yes

No

Prefer not to say
Do you have any religious or cultural needs?*

Yes

No
If yes, please comment*

Do you have any Guardianship or Financial Administration Orders in place?*

Yes

No
If yes, please comment*

Does your child have any food allergies?*

Yes

No
Please note that there will be one mindful eating exercise at some point during the group. Rocky Bay will provide the food item for this exercise.
If yes, please describe*

Are there any other health issues or allergies we need to be aware of?*

Yes

No
If yes, please comment*
Diagnosis*

What does your child hope to gain from the group?
What funding do you receive?*
NDIS - Funds allocated to Rocky Bay
NDIS - Other
WANDIS
Block Funding
Medicare Referral
Privately Funded
Unsure
If NDIS Other, how is your plan managed:*

Self-Managed

Plan Managed
What is your plan manager's email?*

What is your NDIS number?

Plan start and end date:

Do you currently receive services from a Rocky Bay therapist?*

Yes

No
Did your therapist refer you to this group?*

Yes

No
If yes, which Rocky Bay therapist referred you to this group?

Is a goal relating to self-regulation, emotional regulation and/or anxiety management covered in your plan?*

Yes

No
Is your teen able to participate with minimal support in a group setting?*

Yes

No

Unsure
Comment*
What are some of your child’s likes and dislikes?
Does your child behave in a safe manner towards others in a group setting?*

Yes

No

Unsure
Comment*

What supports does your teen need to successfully participate in a group setting?*

Can your teen understand compound instructions (three step instructions or more)?*

Yes

No

Unsure
Comment*

Is your child able to participate in some physical postures and movements throughout the group?*

Yes

No

Unsure
Comment*

Does your child have a tendency to become aggressive, anxious or run away?*
If yes, please provide details of any strategies you have in place to manage/reduce these tendencies.
Does your child use any type of communications device or communication strategies?

Yes

No
Can you please indicate what these might be?*

Is there anything else we need to know before attending the group?*
Where did you hear about Mindful Movers?
Would you like to keep up to date with Rocky Bay news?

Yes

No
Name
This field is for validation purposes and should be left unchanged.
Δ
Δ
Step 1 of 5
Parent Name*
First Last
Phone number*

Email Address*

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Child's name*
First Last
Child's date of birth
MM slash DD slash YYYY

Is the child of Aboriginal or Torres Strait Islander origin?

Yes

No

Prefer not to say
Do you have any religious or cultural needs?*

Yes

No
If yes, please comment*

Do you have any Guardianship or Financial Administration Orders in place?*

Yes

No
If yes, please comment*

Are there any other health issues or allergies we need to be aware of?*

Yes

No
If yes, please comment*
Diagnosis*
What funding do you receive?*
NDIS - Funds allocated to Rocky Bay
NDIS - Other
WANDIS
Block Funding
Medicare Referral
Privately Funded
Unsure
If NDIS Other, how is your plan managed:*

Self-Managed

Plan Managed
What is your plan manager's email?*

What is your NDIS number?

Plan start and end date:

Do you currently receive services from a Rocky Bay Therapist?*

Yes

No
Did your therapist refer you to this group?*

Yes

No
Which Rocky Bay therapist referred you to this group?

Is your child aged between 0 years and 8 years?*

Yes

No
Is a goal relating to language development/communication covered in your plan?*

Yes

No

Unsure
Comment*

Does your child experience issues with paying attention?*

Yes

No

Unsure
Comment*
Does your child experience issues engaging in play with you?*

Yes

No

Unsure
Comment*

Does your child pull and lead you to let you know what they want?*

Yes

No

Unsure
Comment*

Does your child experience issues with using words to communicate or carry on conversations?*

Yes

No

Unsure
Comment*
Is there anything else we need to know before attending the group?*
Where did you hear about Hanen: More than words?
Would you like to keep up to date with Rocky Bay news?*

Yes

No
Phone
This field is for validation purposes and should be left unchanged.
Δ
Δ
- Select a Session and date*
- Parent Name*
- Parent Phone Number*
- Email*
- Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Child Name*
- Child DOB*
  DD slash MM slash YYYY
- Diagnosis*
- 1. What funding do you receive?
  No funding
  Block
  NDIS
  WANDIS
  Unsure
- 2. Do you currently receive services from a Rocky Bay Therapist?
  
  Yes
  
  No
- 3. Did your therapist refer you to this group?
  
  Yes
  
  No
- 4. Is your child aged between 0 years and 12 years?
  
  Yes
  
  No
- 5. Is a goal relating to emotional regulation / behaviour management / family relationships covered in your Plan?
  
  Yes
  
  No
- 6. Does your child experience issues regulating their emotions / behaviours?
  
  Yes
  
  No
  
  Unsure
- 7. Do you have difficulties understanding and interpreting your child’s emotions and behaviours?
  
  Yes
  
  No
  
  Unsure
- 8. Do you feel unsure how to support your child’s behavioural needs?
  
  Yes
  
  No
  
  Unsure
- 9. Can you commit to attending all sessions?
  
  Yes
  
  No
  
  Unsure
- Comments
- Email
  This field is for validation purposes and should be left unchanged.
Δ
Δ
- Select a Session and date*
- Parent Name*
- Parent Phone Number*
- Email*
- Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Child Name*
- Child DOB*
  DD slash MM slash YYYY
- Diagnosis*
- 1. What funding do you receive?
  No funding
  Block
  NDIS
  WANDIS
  Unsure
- 2. Do you currently receive services from a Rocky Bay Therapist?
  
  Yes
  
  No
- 3. Did your therapist refer you to this group?
  
  Yes
  
  No
- 4. Have you completed a 6-week Parenting By Connection Workshop?
  
  Yes
  
  No
  
  Unsure
- 5. Is a goal relating to emotional regulation / behaviour management / family relationships covered in your Plan?
  
  Yes
  
  No
- 6. Does your child experience issues regulating their emotions / behaviours?
  
  Yes
  
  No
  
  Unsure
- 7. Do you feel unsure how to support your child’s behavioural needs?
  
  Yes
  
  No
  
  Unsure
- 8. Can you commit to attending all sessions?
  
  Yes
  
  No
  
  Unsure
- Comments
- Email
  This field is for validation purposes and should be left unchanged.
Δ
Δ
Step 1 of 4
Select a session
Parent or Carer Name*
First Last
Phone number*

Email Address*

Preferred method of contact*
Preferred contact time

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Customer Name*
First Last
Customer date of birth*
MM slash DD slash YYYY

Diagnosis*

Are you of Aboriginal or Torres Strait Islander origin?

Yes

No

Prefer not to say
Do you have any religious or cultural needs?*

Yes

No
If yes, please comment*

Are there any other health issues or allergies we need to be aware of?*

Yes

No
If yes, please comment*
What funding do you receive?*
NDIS - Funds allocated to Rocky Bay
NDIS - Other
WANDIS
Block Funding
Medicare Referral
Privately Funded
Unsure
If NDIS Other, how is your plan managed:*

Self-Managed

Plan Managed
What is your plan manager's email?*

What is your NDIS number?

Plan start and end date:

Do you currently receive services from a Rocky Bay Therapist?*

Yes

No
Did your therapist refer you to this group?*

Yes

No
Which Rocky Bay therapist referred you to this group?

Is a goal relating to communication covered in your plan?*

Yes

No

Unsure
Comment*

What do you hope to gain from the group?
Do you have a communication device or system?*

Yes

No
If yes, what type of device do you have?

Do you have access to the communication device or system (i.e. hands, eye gaze, scanning)?*

Yes

No
Is there anything else we need to know before attending the group?*
Comment or Message
Where did you hear about Tech Talkers
Would you like to keep up to date with Rocky Bay news?*

Yes

No
Phone
This field is for validation purposes and should be left unchanged.
Δ
Δ
Name
This field is for validation purposes and should be left unchanged.

Δ

your partner in possibilty

contact us

60 McCabe Street,
Mosman Park, WA 6012

Phone (08) 6282 1900

ABN 66 028 387 386
ACN 636 892 898

Link to Instagram page Link to Facebook page Link to YouTube channel Link to LinkedIn page

#mygoals

Health + Wellness
Accommodation
Assistive Technology
Daily Living
Social Skills
Parent + Carers
Training
Careers

resources

News
Resources
Easy English Resources
Governance
Funding
Cancellation Appeals
The Hive
Supplier Registration

Join our mailing list

Join our mailing list*
Name
This field is for validation purposes and should be left unchanged.

Δ

NDIS PROVIDER NUMBER
4050002098

Rocky Bay acknowledges the traditional owners of country throughout Australia and their continuing connection to land and community. We pay our respect to them and their cultures, and to elders past and present.

website by: Inkling Success Agency

Skip to content

Open toolbar

Accessibility Tools

Increase Text
Decrease Text
Grayscale
Links Underline
Readable Font
Reset

About us

Team

Our history

Our future

Our commitment to you

Health + Wellness

Accommodation

Assistive Technology

Daily Living

Social Skills

Parents + Carers

Careers

Graduate + Student Placements

Training

Events

Register

Step 1 of 7

Step 1 of 5

Step 1 of 5

Step 1 of 4

contact us

#mygoals

resources