Name

Email Address

Phone No

Does your child facing trouble in making eye contact / reading body language ?
YesNo

Does your child have repetitive movements, motions, / speech patterns ?
YesNo

Is your child rigid towards towards his routine / behavior ?
YesNo

Does your child have increased / decreased sensitivity to specific sensory information from their surrounding, such as negative reaction to specific sound / taste / smell ?
YesNo

Does your child facing difficulty in sharing emotions interest maintaining backs fourth conversation ?
YesNo

Is your Child Speech delayed ?
YesNo

Does your child have narrow range of interest / intense interest in certain topics ?
YesNo

Does your child task in robotic voice / flat voice / sing song voice ?
YesNo

Does your child avoid being hugged / cuddled ?
YesNo

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Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Pediatrics

Joint & Muscle

Skin and Hair Treatment

Allergies

Hormonal Imbalance

GIT

Female Disorder

List Style Disorder

Autism Assessment Test

Autism