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Kid Piling Blocks

Referrals

Intake Form

Sun Rose Children's Therapy accepts referrals from parents, carers, family members, allied health professionals, GPs and other specialists.

To get started with your referral, please fill in our easy online intake form below. If you have information about your child or patient’s diagnosis or medical history, keep it handy to supply with your application.

New Client Intake Form

Thank you for your interest in Sun Rose Children's Therapy. Please complete the form below and we will be in touch to discuss your child's needs and whether our services may be a good fit for your family. 


Child Information

Date Of Birth
Month
Day
Year
Current Year Level
Childcare
Kindergarten
Prep/Foundation
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Secondary School
Not currently attending school
Gender
Is your child Aboriginal and/or Torres Strait Islander?
Anchor 1
Contact

Contact Us

Rear Entrance, 28-30 Sydney Road,Blair St, Coburg VIC 3058

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Opening Hours

Monday: 9 am–8 pm

Tuesday: 9 am–3 pm

Wednesday: 9 am–5 pm
Thursday: 9 am–5 pm

Friday: 9 am–3 pm

Saturday: 9 am–5 pm

Sunday: Closed

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