Downloadable Client Forms

 

New Client Intake Packet

Please complete this packet before coming in as a new client. This packet includes:

  • Intake Form
  • Consent to Share Information Form
  • Photo Release Form
  • Health Insurance Billing Information Form
  • Policies/Procedures Signature and Consent Forms

In addition, you'll need to:

  • Provide a copy of your insurance card  
  • Provide a complete physician's prescription for OT/ST services.

Group Intake Packet

Please complete this packet before your child comes in for group therapy. This packet includes:

  • Intake Form
  • Consent to Share Information Form
  • Policies/Procedures Signature and Consent Form
  • Group Policy Form
  • Photo Release Form

Questions? Please contact us.