First Focus Application Form

Program Intake and Key Dates
Term 2

Initial Assessments: 9 April – 1 May 2025
Assessments held on Wednesdays and Thursdays.

Group Sessions: 7 May – 26 June 2025
Sessions will run on Wednesdays (for 3.5 - 5 year olds) and Thursdays (for 2.5 - 3.5 year olds) at 9:15am and 11:00am.

Post-Intervention Assessments:
Reports issued by 18 July 2025.
Term 3

Initial Assessments: 9 July – 24 July 2025
Assessments held on Wednesdays and Thursdays.

Group Sessions: 30 July – 18 September 2025
Sessions will run on Wednesdays (for 3.5 - 5 year olds) and Thursdays (for 2.5 - 3.5 year olds) at 9:15am and 11:00am.

Post-Intervention Assessments:
Reports issued by 10 October 2025.
Program intake*
Please select your preferred First Focus intake. Spaces are limited, and if your chosen intake is full, we may be able to accommodate you in another current or future intake.
- Term 2 2025 at Osborne Park
- Term 3 2025 at Osborne Park
Participant Details
Child's Name*
First Last
Gender:*
- Male
- Female
- Non-Binary
- Intersex
- Other/Unspecified
- Not known
Age
Please note, only children aged 2-5 years are eligible for this program.
Date of Birth*
Day
Month
Year
Residential Address*
Street Address City ZIP / Postal Code
Is this child currently accessing NDIS funding?*
- Yes
- No
Please note, only children who do not have NDIS funding are eligible for this program.
Is this child currently under the care of the Department of Child Protection and Family Support?
- Yes
- No
Is this child Aboriginal or Torres Strait Islander?*

Parent/Guardian Details
Parent/Guardian Name*
First Last
Relationship to child*
Contact phone*
Email address*
Enter email Confirm email
Main language spoken
- English
- Other
Language spoken (if Other)*
Interpreter required?*
Additional Emergency Contact
Full Name*
First Last
Relationship to child*
Contact phone*
Billing Contact
Will the co-contribution fee be paid by the parent/guardian listed above?
- Yes
- No
To start the program, you will need to pay a small co-contribution of $10 per week or a one-time $80 payment upfront after your assessment is approved.
Billing Contact Name
First Last
Relationship to child
Contact phone
Email address
Enter email Confirm email
Residential Address
Street Address City ZIP / Postal Code

Developmental Concerns

You can find detailed information about child development on the Raising Children Network website: (links open in new tabs)
Child development at 3-4 years | Child development at 4-5 years
Select the areas of development you are concerned about for your child:*
- Movement/gross motor skills (e.g. walking, running, jumping, throwing)
- Fine motor skills (e.g. writing, holding cutlery, fastening buttons)
- Social skills
- Emotional regulation
- Language/communication
- Cognitive skills (e.g. attention, memory, problem-solving)
- Other
Please detail your observations and examples of delayed development in these areas:*
Please list any medical conditions or health concerns:
Please outline why you would like to access the First Focus program:*

Consents and Agreement
I give consent for my child to:
- participate in the First Focus program
- be photographed/recorded for therapeutic and training purposes
  (For internal use by Therapy Focus clinicians and staff only)
- be photographed/recorded for promotional purposes
  (Instances where photographs/recordings may appear include, but are not limited to, Therapy Focus and Telethon's website, social media profiles, digital and printed publications)
How did you hear about the First Focus program?*
GP or health/medical practitioner:
Please provide details:
By submitting this application you agree to the following terms and conditions:
- Approved participants must actively attend and participate in the 8-week therapy program.
- A parent or guardian is required to remain on site at all times during program sessions and assessments.
- I will arrange childcare or alternative care for other siblings, where practical, to maximise the program’s benefits for the enrolled participant.
- I agree to pay the co-contribution of $10 per week or a one-time $80 payment upfront after the initial assessment is approved.
- Therapy Focus will share de-identified participant information, including assessment and report data, with program funders Telethon and Stan Perron.
Agreement*
- I agree to the terms and conditions
Phone
This field is for validation purposes and should be left unchanged.

What are you looking for?

We help people with disability achieve their goals at all life stages

Comprehensive therapies to support your journey

Our therapy services include access to specialised support in key areas

Our therapy groups and programs

Complete the form below to apply for First Focus.

Program Intake and Key Dates

Term 2

Term 3

Participant Details

Parent/Guardian Details

Additional Emergency Contact

Billing Contact

Developmental Concerns

Consents and Agreement

We help people with disability achieve their goals at all life stages

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Comprehensive therapies to support your journey

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Our therapy services include access to specialised support in key areas

Our therapy groups and programs

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About Therapy Focus

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<img src="https://therapyfocus.org.au/wp-content/uploads/2024/04/First-Focus-logo-CMYK-Reversed.png" alt="Lamp" width="320" height="">

Complete the form below to apply for First Focus.

Program Intake and Key Dates

Term 2

Term 3

Participant Details

Parent/Guardian Details

Additional Emergency Contact

Billing Contact

Developmental Concerns

Consents and Agreement