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  • Life Span Occupational Therapy Confidential Intake Data

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Work #: E-mail: Alternate Contact Name Phone: Relationship to patient *Who is the primary or best contact for the patient regarding their appointments? PRIMARY CARE DOCTOR: Phone: Diagnosis (if known) PRIMARY INSURANCE COMPANY Provide a copy of your insurance card Subscriber s Name and Date of Birth SECONDARY INSURANCE COMPANY Provide a copy of your insurance card IF MILITARY PLEASE PROVIDE SS# OF SUBSCRIBER MEDICAID/DSHS (check) Y N If yes, please show your card, inform therapist.

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Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles.

An occupational therapist with an earned doctoral degree from an accredited school, college, or university may use the suffix designating the degree, or the prefix “Doctor” or “Dr.” and add after the person's name the words “occupational therapist”.

No. The OTD is a clinical, practice-oriented doctorate for the advanced clinician. Our OTD program requires you to prepare a professional portfolio. The PhD is a research degree for individuals pursuing a research and/or academic career and requires students to complete a scholarly dissertation.

While some OTs are grandfathered in from the days when a bachelor's degree was standard, a minimum of a master's degree is now required as entry-level OT education. In many schools, a doctorate (OTD) is also being offered.

Occupational therapists aren't medical doctors (MDs) or doctors of osteopathy (DOs). They can't diagnose health conditions, prescribe medication or perform surgeries.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232