Home Our Services Specialised Services Autism Assessments E... Autism Assessment Enquiry Complete the form below and a member of our team will be in touch. Support NeedsPlease select the services you are interested in* Speech Pathology and Psychology Speech Pathology only Reassessment Contact InformationName of Parent / Caregiver* First Last Preferred method of contact* Mobile Email Phone Post Mobile*PhoneEmail* Enter Email Confirm Email Residential Address* Address Suburb Postcode Service UserName of person requiring assessment* First Last Current Therapy Focus customer?* Yes No Gender* Male Female Non-Binary Intersex Other/Unspecified Not known Pronouns He/Him/His She/Her/Hers They/Them/Theirs Date of Birth:*DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AgePlease note: Our autism assessment service is for children over three years of age and young people under 18.Please note: Our autism assessment service is for children over three years of age and young people under 18.Country of Birth:*Please select...AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsAre you Aboriginal or Torres Strait Islander?*Please selectNo knownAboriginal but not Torres Strait IslanderTorres Strait Islander but not AboriginalBoth Aboriginal and Torres Strait IslanderNeither Aboriginal nor Torres Strait IslanderLanguage Spoken:* English Other Language other than English*Language other than EnglishAAcehAcholiAfarAkan (alt Twi/Fanti)AlbanianAmharicAnuak (alt Anyuak)ArabicArmenianAssyrianBBari (alt Kuku/Beri)Bengali (alt Bangla)BielorussianBislamaBosnianBulgarianCCantoneseCebuanoChaldeanChichewa (alt Chewa/Chinyanja/Nyanja)Congo SwahiliCroatianCzechDDariDinkaDutchEEstonianEweFFalam ChinFarsi (alt Persian)Fiji HindiFijianFilipino (alt Tagalog)FinnishFrenchFulfulde (alt Fulani)Fullah [Sierra Leone/Guinea]Fuqing [Dialect of Min Dong Chinese]Fuzhou [Dialect of Min Dong Chinese]GGandaGermanGorani (alt Hawrami)GreekGujaratiHHakha ChinHakka ChineseHarariHausaHazaragiHebrewHindiHindustaniHmongHokkien [Dialect of Min Nan Chinese]HungarianIIgbo (alt Ibo)IndonesianItalianJJapaneseJingpho (alt Kachin)Juba Arabic (alt Sudanese Creole Arabic)KKakwaKannada (alt Kanarese)Kayah (alt Karenni)KhmerKinyarwandaKirundi (alt Rundi/Urundi)KissiKonyanka Maninka [Mandingo]KoreanKrioKurmanji Kurdish (alt Northern Kurdish/Ezdiki)LLaoLiberian EnglishLingalaLisuMMacedonianMa'di [Uganda/South Sudan]Malay (alt Melayu)MalayalamMalteseMandarinMara ChinMarathiMatu ChinMende [Sierra Leone/Liberia]Mizo ChinMonMongolianMuun Chin (alt Mindat)Myanmar Language (alt Burmese)NNepaliNorth AzerbaijaniNorwegianNuerOOromoPPashtoPijin (alt Solomons Pidgin)Pojulu [Dialect of Bari]PolishPortuguesePulaar [Senegal]PunjabiPwo Eastern KarenRRohingyaRomanianRussianSSabaotSahoSamoanSangoSerbianS'gaw KarenShanShanghai [Dialect of Wu Chinese]Shona (alt Chishona)Sichuanese [Dialect of Mandarin]SidamoSindhiSinhaleseSlovakSloveneSomaliSorani Kurdish (alt Central Kurdish)South AzerbaijaniSouthern Kurdish [Feyli]SpanishSudanese ArabicSusuSwahili (alt Ki-Swahili)SwedishSyriacTTaiwanese [Dialect of Min Nan Chinese]Tajiki (alt Tajik)TamilTedim Chin (alt Zomi [Myanmar])TeluguTeochew [Dialect of Min Nan Chinese]Tetun (alt Tetum)ThaiThemne (alt Temne)TibetanTigreTigrinyaTok PisinTonganTurkishTurkmenTuroyoUUkrainianUrduUyghur (alt Uighur)UzbekVVietnameseZZandeZoAny established diagnoses?* Yes No Please note: NDIS funds cannot be used for the assessment.Are you able to attend a nearby Therapy Focus office?* Yes No Do you have a referral from a paediatrician to Therapy Focus?* Yes No