Our little one's bowel and bladder concerns are as equally as important as our own. Sometimes we may need to provide them with some help and assistance.

WE CAN HELP WITH

WHY THEY NEED US!

Bladder and bowel concerns can not only be detriment to your child's physical, but also psychological and mental health.Its important to address their concerns early on to prevent lifelong habits and ongoing distress.

Child's Name

First Name

Last Name

Date of Birth

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Parent/Guardian's Name

First Name

Last Name

Phone

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Email

Brief History

Funding:

If not parent/guardian : please provide contact details.

REFERRAL