This will help to identify if your child is a candidate for an INPP reflex integration program. Please fill out all questions and we will arrange a free follow up call. I acknowledge this form is very long and will take approximately 20 minutes to fill in but the more information you give me now the faster I will be able to assess where your child may be struggling and how best to help. 

Paper questionnaires available on request.

To see how Star of the Sea Therapy processes your data, please refer to our Privacy Policy.