Home
Forms Library
Occupational therapy intake form template

Occupational therapy intake form 2026

occupational therapy intake form template Preview on Page 1

See details

4.5 out of 5

61 votes

The document is an Occupational Therapy Intake Form designed to collect comprehensive information about a new client, including personal details, previous therapy services, diagnoses, childhood illnesses, self-care skills, and concerns regarding motor skills and behavior. It aims to assess the child's needs for occupational therapy by gathering relevant medical history and current challenges.

Here's how it works

01. Edit your occupational therapy intake form template online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send pediatric occupational therapy intake form via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out occupational therapy intake form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the occupational therapy intake form in the editor.
Begin by filling out the NEW CLIENT INFORMATION section. Enter the date, gender, patient name, and the person completing the form. Ensure you provide accurate details for DOB and age.
In the PREVIOUS SERVICES section, indicate whether your child has received services like Speech/Language Therapy or Occupational Therapy by selecting 'Yes' or 'No'. Include any other specialists if applicable.
For DIAGNOSIS, check all relevant conditions that apply to your child. Provide information on who provided the diagnosis and what criteria were used.
Move to CHILDHOOD ILLNESSES/PROBLEMS. Check any applicable issues and provide comments as needed. List current medications and any evaluations related to vision/hearing.
Complete sections on self-care skills, school concerns, gross and fine motor skills, movement and balance issues, and treatment goals by checking boxes and providing detailed responses where required.

Start using our platform today for free to streamline your occupational therapy intake process!

See more occupational therapy intake form versions

We've got more versions of the occupational therapy intake form form. Select the right occupational therapy intake form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2016	4.5 Satisfied (61 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I sign my occupational therapy intake form with my phone?

Sure, it is possible with DocHub. This secure and compliant online solution has a phone-based signing option. Once you log in to your DocHub account and add your occupational therapy intake form to our editor, fill out all empty fields and use the Sign feature on the top barf. Click on Create your signature and choose Phone from the available choices. Here, you scan a QR code using your smartphone and draw your signature on your phone screen, as you usually do when approving hard copies. If you access DocHub right from your mobile device, you can electronically sign your paperwork by drawing your electronic signature, adding its picture, or simply with a typed name.

How do you complete occupational therapy intake form on iOS?

You need only a web connection and a web browser to complete your occupational therapy intake form on an iOS phone. Open the DocHub website and authenticate. Then, add your document or select it from the list in your dashboard. Then use our editing instruments to complete your form and save all your modifications. You can also send it to a specified recipient straight away.

What is the purpose of the intake form?

What's an intake form? An intake form helps service providers streamline the client onboarding process and easily gather information from new clients. This questionnaire is a way for you to get to know your clients in the early stages of your relationship with them.

What should an intake form include?

So let's look at some of the information you might decide to include: Your client's name, surname, and contact information (mobile number, email address, home address, website, etc) Information about your client's business and brand (if applicable) Your client's budget (if applicable)

What is the purpose of an intake assessment?

An intake assessment is a checklist of considerations that healthcare professionals use to determine the well-being of a patient and the type of treatment options that might be appropriate. This assessment is typically conducted before a patient receives mental health treatment.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

Related forms

be ready to get more