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  • Home
  • About Little Hiccups
    • About Us
    • Welcome Pack
    • FAQ
    • Meet The Team
    • Patron – Maddie Thompson
    • Awards and Certifications
    • Supporters and Affiliates
    • Policies and Procedures
  • How We Support
    • –
      • Stay n’ Play
      • Family Fun Days
      • Parent/Carer Events
      • Hydrotherapy
      • Physio Assessment and Advice
      • Accessible Yoga Sessions
    • –
      • All Terrain Buggy Hire
      • Travel Bed Hire
      • Stabilo Bagel Hire
      • Counselling
      • Compassion Packs
      • Mosaic Trail
    • –
      • Max Card
      • Educational / Informative
      • The Principle Trust Holidays
      • Ison Harrison Solicitors – Making a Will
      • Other Information
  • Get Involved
    • Volunteering
    • Fundraising
    • Corporate Sponsorship
    • Charity Lottery
    • Will Legacy
    • Give As You Live
    • Nectar Donate
    • Donate
  • Upcoming Events
    • All Events
    • Family Fun Days
    • Parent/Carer Events
    • Stay n’ Play
    • Educational / Informative
    • Fundraising
    • Annual Charity Ball
  • Blog
  • Contact
  • DONATE
  • Store
    • Shop at Little Hiccups
    • Cart
    • Checkout
  • Login
    • Login/Register
    • Update My Details

Hydrotherapy

Improving pain relief, mobility, strength and balance

Hydrotherapy Booking Form

Please find below the form that you will need to complete to book onto the Hydrotherapy sessions with Little Hiccups.

Please refer to the Essential Inclusion Criteria below and how your child fits this criteria.

ESSENTIAL INCLUSION CRITERIA

  • A specific neurological condition that affects gross motor skills and mobility such as:
    • Cerebral palsy, acquired brain injury, spinal injury, muscular dystrophy, genetic conditions
  • Delayed development in gross motor skills, which may or may not be linked to a specific diagnosis, such as:
    • Requiring help with sitting, crawling, standing, walking
  • Experiencing issues such as:
    • Tight muscles, weak muscles, issues relating to posture, balance, coordination
  • Experiencing joint or muscle pains
  • Experiencing specific difficulties with coordination and balance; linked to on-land activities

What is important to acknowledge that these sessions are not designed to help with the below in isolation:
  • Teaching swimming skills
  • Developing water confidence
  • Sensory integration
Whilst hydrotherapy could impact the above, all children being offered a place should be able to link their needs to some part of the essential criteria & key benefits.

    Child's Details

    Please complete the next two questions with as much information as you can. Please include as much information as possible about their goals and areas of development. The information you give will help with the selection criteria process.


    Parent/Carer Details

    Please enter details of the parent supporting the child in the pool


    Support Needs

    Will your child need any of the following:



    How will your child enter the pool:





    Medical Conditions

    Please let us know if you or your child have any of the following medical conditions or problems. Please complete for the child and also the parent/carer supporting the child in the pool.

    Will be unable to enter the pool:

    1. Acute vomiting or diarrhoea:

    2. Medical instability following an acute episode such as stroke, DVT, BP problems:

    3. Chlorine/Bromine allergy:

    4. Resting angina:

    5. Shortness of breath at rest:

    6. Uncontrolled heart failure:

    7. Weight in excess of evacuation equipment limit (21 stone/127kg):

    Hydrotherapy may be considered after a risk analysis:

    8. Acute systemic illness:

    9. Irradiated skin during course of radiotherapy:

    10. Known aneurysm:

    11. Open infected wounds:

    12. Poorly controlled epilepsy:

    13. Unstable diabetes:

    Precautions:

    14. Fear of water:

    15. Behavioural problems:

    16. Bowel and bladder disorders or incontinence of urine or faeces:

    17. Epilepsy:

    18. Haemophilia:

    19. Widespread MRSA:

    20. Hypotension:

    21. Renal Failure:

    22. Poor skin integrity:

    23. Pregnancy (if water temperature less than 35 degrees):

    24. Contact lenses or conjunctivitis:

    25. Hearing aids:

    26. Impaired sensation/vision/hearing:

    27. Invasive tubes in situ:

    28. Dizziness or blackouts:

    29. Spinal cord or neck problems:

    30. Kidney disease:

    31. Blood pressure problems:

    32. Osteoporosis:

    33. Recent fractured bones:

    34. Recent surgery:

    35. Other medical problems:


    Slot Date Preference

    Please let us know if you have a preference of dates. You can select more than one option. Please leave blank if no preference.
    This cannot be guaranteed but we will try to fulfil all requests.

    Slot Time Preference

    Please let us know if you have a preference of times. You can select more than one option. Leave blank if no preference:
    This cannot be guaranteed as factors such as use of slings/changing rooms and a mixture of ability in the pool will take precedence. But we will try to fulfil all requests.


    Support in the water

    We ask parents/carers to support their child in the water. However, there are a few reasons why you may not be able to. Please contact us on info@littlehiccups.co.uk if you are unsure and have any questions. Please let us know so if needed we are able to source volunteers to ensure numbers remain at safe levels.

    I am able and willing to be in the water with my child:


    Photo permissions

    I give permission for Little Hiccups to take photographs and / or video of my child.

    I grant Little Hiccups full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

    You have the right to opt out at any time.

    I am happy for photos and video of my child to be taken:


    Electronic Signature

    By submitting this form, I certify that the above information is correct, and I agree to promptly communicate any future changes to the above prior to use of the Hydrotherapy pool.

    I give my consent for my son / daughter to participate in the pool / hydrotherapy sessions.

    I also confirm that to the best of my knowledge (unforeseen circumstances aside) I will be able to attend all sessions.

    Please keep in mind that all children must be supervised by their parent/carer at all times.

    All information and photos will be stored according to the Data Protection Act 1998 and the GDPR Act 2018. Information collected will be used for Little Hiccups purposes only. We will not share your information with any other companies or organisations other than the Grant which will be anonymous.

    Please contact us if you have any questions about our privacy notice or information we hold about you. You can contact us by email at info@littlehiccups.co.uk

    You can see the full privacy notice on our website at https://www.littlehiccups.co.uk/privacy.htm

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    Upcoming Events

    25 in '25 - Virtual Running Challenge
    25 in '25 - Virtual Running Challenge
    22 Jan 25
    TBC
    Hydrotherapy Sessions - May 2025
    Hydrotherapy Sessions - May 2025
    31 May 25
    Leeds
    2025 06 Wellbeing for Parents Yoga Course
    2025 06 Wellbeing for Parents Yoga Course
    2 Jun 25
    Leeds
    Stay n Play - Monday morning session
    Stay n Play - Monday morning session
    23 Jun 25
    Leeds
    Stay n Play - Thursday afternoon session
    Stay n Play - Thursday afternoon session
    26 Jun 25
    Leeds

    Fresh from our Blog

    • A Wildly Wonderful Day at Ponderosa Zoo with Little Hiccups!
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    • Wild Wellness in the Woods: A Relaxed Evening Outdoors

    Get to know us

    Little Hiccups is a Leeds based support group that has been set up by parents who have children with additional needs.

    Through personal experience they recognise the importance of allowing the parents and families of a child with a disability the opportunity to meet people in similar situations, to make friends and support each other.

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    Contact Info

    • Little Hiccups
    • c/o The Barrowbys, 170 Barrowby Lane, Garforth, Leeds, LS25 1NG
    • 07831230741
    • info@littlehiccups.co.uk
    • https://www.littlehiccups.co.uk

    Charity Details

    Little Hiccups is a Company limited by Guarantee - Company number 09692276

    Little Hiccups is a Registered Charity
    Charity Number 1170147

    Blog

    • A Wildly Wonderful Day at Ponderosa Zoo with Little Hiccups! June 11, 2025
    • Another Sizzling Success: East Ardsley Conservative Club Raises Ā£777.20 for Little Hiccups! May 27, 2025
    • šŸŒ™ Little Hiccups Eid Celebration at Aagrah Garforth – A Morning of Food, Fun, and Festivities May 27, 2025
    • A Lasting Tribute to Athena: Templegate Tiny Tots’ Forest School Gazebo May 21, 2025
    • Wild Wellness in the Woods: A Relaxed Evening Outdoors May 19, 2025

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