WESTERN KIDS HEALTH - Telehealth Services for Dietitian
The situation in our community regarding the COVID-19 Pandemic is fluid and has changed the way we deliver services to our clients, to prioritise the health and wellbeing of everyone in the Western Kids Health Family, our children, their families and our staff.
However babies, children and teens still need to access essential allied health services, to optimise their physical, emotional, social and mental wellbeing.
We are using Telehealth, a secure virtual video platform, to ensure that we can deliver our premium services to our children, their families and the broader community.
If you are interested in booking an individual appointment/package or a group, please fill out this google form and our administration team will contact you
Child's Full Name
Child's Date of Birth
Is your child currently a patient (as attended within 18 months) at Western Kids Health?
Parent/Guardian Name and Contact Details (please include contact number and email address)
Diagnosis (if known)
Main concern or reason for referral to Western Kids Health?
Were you interested in any of the Dietitian Packages for your child listed below?
All packages include Video consultation/s, personalised programs and email or in-app follow ups
Basic Package - 1 appointment
Standard Package - 3 appointments
Extensive Package - 6 appointments
Are you interested in any of the Dietetic Virtual Groups, if so please select below:
Any additional comments regarding the reason for seeking dietetic services?
Thank you kindly for completing the questionnaire. We look forward to meeting you and your child at your assessment. If you have any questions or would like to get in touch please contact us at (08) 6112 2977 or email@example.com
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This form was created inside of Western Kids Health.