Thriving Inc. Exercise for Young People - New Enquiry Form
Please complete the family interview form below to give us a bit of an idea of your child's strengths, challenges and goals. If you would prefer to discuss the questions with a team member via phone instead, please indicate this below and the best time to contact you.

If you are interested in enrolling multiple children, please complete a separate form for each.

Thank you :)
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Email *
Parent/Guardian Name *
Child Preferred Name *
Child Age *
Child's gender
Which of our services are you interested in? *
Phone number & preferred contact time
How did you find out about Thriving?
Clear selection
If relevant, please provide details of referral (i.e. who, clinic/service details, reason for referral)
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