State Occupational Therapy Regulatory Authority Contact 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the PT Certification number, Date of Injury, and Initial PT Treatment Date in the designated fields. This information is crucial for tracking treatment history.
3. Fill in the Patient Information section with the patient's name and Social Security number. Ensure accuracy as this data is essential for identification.
4. Provide details about the Employer and Diagnosis. This helps in understanding the context of treatment and any work-related issues.
5. Indicate Hand Dominance by selecting either Right or Left. This can influence treatment approaches.
6. Select applicable Treatment Modalities from the list provided. You can check multiple options that apply to the patient’s treatment plan.
7. Summarize therapeutic exercises and work hardening programs in their respective sections, ensuring clarity on prescribed activities.
8. Complete the Assessment of Current Functional Status by noting improvements or changes since previous treatments, including pain ratings and range of motion.
9. Finally, fill out Treatment Goals & Return to Work sections, including projected discharge dates and recommendations for further care.

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