Client Intake Form This form is an interactive PDF; you can fill it out in Acrobat Reader. (If you dont have Reader, download it here. ) There are three ways to get the completed form back to us.
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How to fill out the Client Intake Form - Kids Therapy Made Simple online
Completing the Client Intake Form for Kids Therapy Made Simple is a crucial step in initiating your child's therapy journey. This guide provides step-by-step instructions to help you fill out the form accurately and efficiently.
Follow the steps to complete the Client Intake Form online.
- Press the ‘Get Form’ button to access the Client Intake Form, which you can fill out online using a compatible PDF editor.
- Begin by entering the name of the person filling out the form. Make sure to include the date as well.
- Next, provide your child's name and date of birth, along with your occupation and primary language spoken at home.
- Fill in the details of the pediatrician, including their name, occupation, and phone number.
- Detail the home address and list the names and ages of all individuals currently living in the home.
- Indicate how you heard about Kids Therapy Made Simple and any other relevant information.
- Address the reason for your child's evaluation by describing the difficulties you have observed.
- Complete the sections regarding your child's attendance at daycare or school, previous evaluations or therapies, and current interventions.
- Fill out various medical history questions, including birth history, nutritional history, and any existing medical conditions or medications your child may have.
- Provide social and emotional information by describing your child's personality, interests, and relationships with peers.
- If applicable, enter educational history details, such as the name of your child's current school and any special education services.
- Once you have filled out all sections, save the completed PDF file, ensuring it is stored securely.
- To submit the completed form, either email it as an attachment to info@ktms.us or use the submission button available within the form.
Get started on your child's therapy journey by completing the Client Intake Form online today.
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