Get Occupational Therapy Evaluation

Completing the Occupational Therapy Evaluation form online can be a straightforward process with the right guidance. This guide will provide you with step-by-step instructions to ensure that you fill out every section accurately and effectively.

Follow the steps to successfully complete the Occupational Therapy Evaluation form online.

1. Press the ‘Get Form’ button to retrieve the Occupational Therapy Evaluation form and open it in your preferred digital editor.
2. Begin by entering the patient’s last name, first name, and middle initial in the designated fields.
3. Next, input the patient's identification number and health insurance claims number as required.
4. In the 'Reason for Referral' section, briefly describe the reason for the evaluation, ensuring clarity and conciseness.
5. Record any relevant precautions that the therapist should be aware of during the assessment.
6. Determine and indicate the level of assistance required for the patient, using the codes provided: Independent (I), Modified Independent (M), Stand By Assist (SBA), Supervision (S), Contact Guard Assist (CGA), Minimum (Min), Moderate (Mod), Maximum (Max), or Dependent (D).
7. For activities of daily living, select the level of assistance for each task listed: feeding, grooming, upper body bath, lower body bath, upper body dressing, lower body dressing, toileting/hygiene, and homemaking skills. Include any pertinent comments.
8. In the section for adaptive equipment and positioning, specify the current seating arrangement and whether it is appropriate.
9. Fill out the 'Functional Mobility' section, analyzing the patient's balance and indicating the level of assistance needed for rolling, transitioning to/from sitting, bed mobility, and toilet access.
10. Evaluate the range of motion (ROM) and strength in upper extremities by documenting active range of motion (AROM) and passive range of motion (PROM), along with any relevant strength measures and comments.
11. Assess sensory integration and cognitive function by marking the appropriate statuses for sensation, perception, and cognitive capacities including judgment, memory, and safety awareness.
12. Finally, ensure that the therapist signs and dates the form, includes their credentials, and that the physician’s name is clearly noted.
13. Once all fields are completed, save any changes made, and proceed to download, print, or share the completed Occupational Therapy Evaluation as needed.

Begin your Occupational Therapy Evaluation online and complete the necessary documentation with ease.