Gameplan PEERS (Adolescents) Register Your Interest

PEERS for Adolescents is a 16-week evidence-based, social and emotional learning (SEL) programs for motivated teens or young adults who are interested in learning new ways of making and keeping friends, handling bullying and disagreements, and navigating social situations across the life span.

During each group session, teens and young adults are taught important SEL skills and are given the opportunity to practice these skills both in and out of the groups.

Parents/caregivers attend separate sessions at the same time and are taught how to assist their teens or young adults in their daily living environments.

Session dates: Tuesdays Term 1 & 2 / 3 & 4 2023

Session duration: 90-minute session for adolescents, and social skills training sessions for parents running concurrently in separate online meetings.

Fees: PEERS Term Program Subscription = $5,650.00 ((includes 2 participants: adolescent and parent attending 16 sessions).

Payment: Weekly, monthly, or program-based (5% discount) payment options are be offered.

Funding and rebate options: Medicare, NDIS and private health insurance.

T&Cs: Gameplan’s T&Cs apply.

Please complete and submit the form to register and confirm your interest in participating in Gameplan’s PEERS program in 2023. A Gameplan Team member will then be in contact with you asap.

Regsitration Form

Your Full Name

First Name

Last Name

Mobile / Phone

(###)

###

####

Your Email Address

Your Residential Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your relationship to your adolescent?

Your adolescent's Details

Full Name

First Name

Last Name

Date of Birth

DD/MM/YYYY

Preferred pronouns

E.g. she/her, he/him, they/them, other combination

School Attending

Please enter the name and suburb of the school your teen is attending.

Current Year Level

Primary language spoken at home?

Current Diagnoses/Medical conditions?

Previous assessments:

Please outline any previous assessments your teen may have received, and the source(s) of these assessments.

Please describe your adolescent's social and/or communication differences and any challenges experienced:

Have you spoken to your adolescent about the PEERS program?

Yes

No

Is your adolescent willing to participate weekly in the PEERS program?

Yes

No

Unsure

Are you willing to participate weekly in the PEERS program?

Yes

No

Do you have NDIS funding?

Yes

No

What are you looking to achieve by participating in the PEERS for Adolescents program?

How did you learn about Gameplan's PEERS program?

still have questions? e-mail gameplan