This link contains referral documents to be used by speech pathologists or psychologists. If you are a parent/caregiver and you wish to refer your child to the NEMLDC, please talk to a speech pathologist who can start the process if appropriate.

Speech Pathologists/Psychologists:

Word versions of referral forms:

• Speech Pathology Reports:
  • 2018 LDC Kindy Referral Speech Pathology Report
  • 2018 LDC Pre-Primary Referral Speech Pathology Report
  • 2018 LDC Year 1 Referral Speech Pathology Report
  • 2018 Appendix 1 CALD Questionnaire
  • 2018 Parent Carer Kindy Questionnaire
• Parent/teacher Questionnaires:
  • 2018 Parent Carer Kindy Questionnaire
  • 2018 Teacher Questionnaire for PP placement
  • 2018 Teacher Questionnaire for Year 1 placement
• Other Documents:
  •  LDC Referral Guideline Document (2018)
  • Assessment Scoring Information for Speech Pathologists (2018)
  • 2018 LDC Behaviour Checklist School Psychologists

These forms may be filled out by hand, scanned and attached to an email (northeastmetro.ldc@education.wa.edu.au) OR posted them to the NEMLDC:

The Referral Officer

North East Metropolitan Language Development Centre

18 View Street

Dianella, 6059

Click here for the PDF version for referral forms for electronic submission

Back to Referral and Enrollment Information