
Get Occupational Therapy Intake Form 2020-2025
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How to fill out the Occupational Therapy Intake Form online
Completing the Occupational Therapy Intake Form online is an essential first step in receiving tailored therapy services. This guide will provide you with clear instructions on filling out each section of the form, ensuring that all necessary information is accurately submitted.
Follow the steps to complete the Occupational Therapy Intake Form effectively.
- Click ‘Get Form’ button to obtain the form and open it in a digital format suitable for editing.
- Start with the ‘New Client Information’ section. Fill in the date, patient's name, and date of birth. Indicate the person completing the form and their relationship to the patient. Select the gender by marking the appropriate box.
- In the ‘Previous Services’ section, indicate whether the patient has received services such as speech/language therapy, occupational therapy, physical therapy, or psychological counseling by selecting yes or no for each type. If applicable, list any other specialists and the dates of past therapies.
- For the ‘Diagnosis’ section, check all applicable diagnoses such as autism spectrum disorder or attention deficit disorder. Provide details about who provided the diagnosis and the basis for it.
- In the ‘Childhood Illnesses/Problems’ section, check any illnesses that apply. Provide the age at which these occurred and any comments that may help in understanding the child’s history.
- List all current medications in the specified area, and document any vision or hearing evaluations or treatments received.
- Answer questions regarding the child’s general health, injuries, self-injurious behaviors, fears, and strengths. This information helps tailor the therapy approach.
- Indicate the child’s self-care skills by checking the appropriate boxes that correspond to their level of independence in tasks like dressing or eating.
- Provide information on the child's school or daycare attendance, and detail any concerns that have arisen in educational settings.
- In the ‘Gross and Fine Motor Skills’ section, check any relevant boxes indicating difficulties the child may experience, and offer additional details as needed.
- For the ‘Movement and Balance’ section, check all applicable issues and provide details about the child’s physical activities and challenges.
- In the ‘Treatment Goals’ section, outline three specific problems you would like to address in therapy and rate their severity.
- After filling out all sections, review the form for accuracy and completeness. Once satisfied, save changes, and choose to download, print, or share the form as necessary.
Take the first step towards effective therapy by filling out the Occupational Therapy Intake Form online today.
When writing an OT progress note, focus on documenting the client's progress since the last session. Include specific observations, changes in performance, and any adjustments to therapy goals. Summarizing this information clearly helps track the client's development effectively. A structured Occupational Therapy Intake Form can aid in consistently documenting relevant progress.
Fill Occupational Therapy Intake Form
Please complete the following form to the best of your ability. We recognize that this can be a very overwhelming and time consuming. Describe your reason for seeking occupational therapy for your child at this time. What issues are you looking to have resolved? How will you know that things have changed and that you have gotten better? Child Information. Name. Who referred you to Occupational Therapy ? Complete our intake form. This may take 10 minutes to complete. You are welcome to print the paper version of this form.
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