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Get TMHP Seating Assessment Form 2011

Ent is in school, has a school therapist been involved in the assessment? Yes No Name of school therapist: Name of school: Page 3 of 7 Effective Date_07012011/Revised Date_05312011 V. Environmental Assessment School therapist’s telephone number: Describe how the wheelchair will be transported: Describe where the wheelchair will be stored (home and/or school): Describe other types of equipment which will interface with the wheelchair: VI. Requested Equipment: Describe client’s curren.

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