Hydrotherapy Intake - Kayla's Children Centre

Private Hydrotherapy with PT or OT
The benefits of hydrotherapy and swimming for individuals with disabilities and medical needs are significant. In the warm waters, individuals with mobility challenges can be independent, flexible, and free; they can build strength, muscle tone, endurance, and balance. The benefits are not only physical, but mental and emotional as well.

Our skilled physiotherapists and occupational therapists provide personalized guidance to ensure each session is safe, effective, and tailored to individual goals.

Private Session Cost:
• $130/session
• $90/session for KCC students

Parent/Guardian Name*
First Last
Phone*
Email*
Child's Name*
First Middle Last
Child's age*
Child's date of birth*
Child's gender
Relationship to child
Current program or school & grade*
Level of support in classroom/program*
Why are you interested in hydrotherapy for your child? What are your main concerns?*
Please specify your child's diagnosis(es)*
Child's strengths*
Child's needs*
Medical history*
Past or current therapies*
Describe your child's level of communication*
Describe your child's level of mobility*
Describe your child's level of independence while dressing, showering, toileting, feeding*
Safety concerns*
Sensory concerns*
Anything else you would like to share about your child*
Languages spoken at home*
Is your child currently enrolled, or have they previously been enrolled, in other KCC programs? Please specify (School, camp, other therapies)*
What is your availability?*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Sunday
What is your preferred appointment time?*
- Morning
- Afternoon
- Evening
How did you hear about us?*
- We are a current KCC family
- Instagram
- Facebook
- Billboard
- Word of mouth
- Other

Private Hydrotherapy

Private Hydrotherapy

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