Registration & Forms

Registration & Forms

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Notice of Privacy Practices Form

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For Everyone:

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Authorization For the Release of Information Form

Online Form or Downloadable PDF

Patient/Client Registration Form

Online Form or Downloadable PDF

Patient Service Agreement - Form - *NOTE: This form is on the website for information/reference purposes. Clients are to sign this form ONLY at the office with a Therapy Associates employee.

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Occupational Therapy Patients:

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Sensory History Form

Online Form or Downloadable PDF

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Feeding Therapy Patients:

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Feeding Program Intake Form

Online Form or Downloadable PDF

Feeding History Form (Age 2 & Under)

Online Form or Downloadable PDF

Food Journal - 3 Day - Download only

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Speech & Occupational Patients Only:

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Health Insurance Benefits Worksheet

Online Form or Downloadable PDF

Child Case History Form

Online Form or Downloadable PDF

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Mental Health Department Only:

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Social Work Client Bill of Rights - Download only

Marriage & Family Therapy Client Bill of Rights - Download only

Psychology Client Bill of Rights - Download only

Family History Questionnaire

Online Form or Downloadable PDF