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Application for dolphin therapy in Odessa - NEMO
Child’s information:
The child’s full name *
Date of birth *
Child's Height (sm)
Weight of child (kg)
Main/concomitant diagnosis *
Epileptic seizures, convulsive readiness
Yes
No
Cancer
Yes
No
Contact information:
Parents’ full names *
Contact phone *
Email: *
Your address
Convenient dates: from
till
Requested services: (tick off where appropriate)
Dolphin therapy sessions
Rehabilitation procedures
Psychological and pedagogical
Psychologist
Sensory room
Speech-language pathologist
Therapeutic speech massage
Department of physiotherapy and massage
Therapeutic exercises
Bobath therapy
Taping
Therapeutic exercises and massage
Craniosacral therapy
Physical rehabilitation
Electric stimulation of speech
Laser therapy
Muscular stimulation of articulation muscles
Transcranial Doppler sonography
Magnetic therapy
Ultrasound therapy
Accommodation
Desired number of sessions:
Tell us how you learned about us:
Additional information
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