Follow the steps to complete the KOTP Intake Form successfully.

1. Click ‘Get Form’ button to access the KOTP Intake Form and open it for editing.
2. Fill in the child's name at the top of the form, followed by today's date and the child's date of birth.
3. Provide the email address, home address, and contact information for both parents, including occupation, home phone, cell phone, and work phone.
4. Indicate the primary language spoken in the home and the pediatrician's name along with their contact number.
5. Provide your insurance details, including the insurance carrier, member ID, and the subscriber's information, including their date of birth.
6. In the diagnosis and concerns section, list any specific issues or health concerns related to your child.
7. Detail any other therapies your child has received, including the facilities' names, if applicable.
8. Complete the emergency contact information with a name, relationship to the child, and both home and cell phone numbers.
9. Document any allergies or restrictions your child may have.
10. If applicable, provide consent for treatment, and fill in necessary medical history, developmental history, and milestones achieved by your child.
11. Complete the child profile section with your child's interests and activity level.
12. Finally, after filling out the form, save your changes and download, print, or share it as required.

Start filling out the KOTP Intake Form online today to ensure your child's therapy begins as smoothly as possible.