Get Ca Goodfellow Occupational Therapy Client Intake Packet 2017-2025

Filling out the CA Goodfellow Occupational Therapy Client Intake Packet online can streamline the intake process for therapy services. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete your intake packet online.

1. Click ‘Get Form’ button to obtain the CA Goodfellow Occupational Therapy Client Intake Packet and open it in your preferred online document editor.
2. Enter the date of intake in the designated field. This is typically found at the top of the form.
3. Fill in the client information section, including the client's name, date of birth, address, city, zip code, home phone, and cell phone. Provide any referral information and circle your preferred contact method.
4. Complete the parent/guardian information section by entering the necessary details about the client’s parent or legal guardian. Include their name, address, phone numbers, email, marital status, and if appropriate, the spouse's name.
5. In the responsible party information section, provide the insured’s name, insurance company, insured's social security number, and other related details including their date of birth and employer.
6. Read and acknowledge the policies regarding sickness, illness, and injury. This includes understanding the circumstances under which a child will not be seen for therapy.
7. Sign and date the authorization for treatment section, indicating consent for evaluation and treatment of your child.
8. Fill out the intake history sections which ask for developmental history, concerns about the child, current care providers, and medical history. Answer each question with as much detail as necessary.
9. Complete any sections related to emergency contact information, medical consent, and authorization for releasing information as required.
10. Review all completed sections to ensure accuracy and comprehensiveness. Once satisfied with your entries, you can save your changes, download, print, or share the completed form as needed.

Begin filling out the CA Goodfellow Occupational Therapy Client Intake Packet online to streamline your intake process.