Downloads

Download Intake Packet

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The initial intake packet must be downloaded and filled out along with the discipline specific forms below. Please note: if your child is under one year of age, this form can be found condensed in the Baby Initial Intake Packet below, and does not need to be filled filled out. Everyone must download, thoroughly read and sign our Attendance and Cancellation Policy.

If you are not sure how to sign a PDF file, here is a guide, but feel free to leave the signature spaces blank and sign by hand after printing.

Do not email completed forms. Please print them out and bring them with you for your eval, as that streamlines the intake process. If you don’t have access to a printer, these forms will be provided to you at the office, but make sure to arrive 20 minutes before the time of your appointment so you have enough time to fill them out before your child is scheduled to be seen.

Discipline Specific Forms (ages 1 and up)

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If your child is being seen for OT and/or Speech, please make sure to download and fill out both the OT/Speech intake packet and the sensory checklist.

The sensory checklist is not required if your child is being seen only for PT, but please download and fill out the appropriate intake packet.

Baby (0-12 months) Forms

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Please download and fill out both the intake packet and the sensory checklist.