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PT OT Therapy Intake Form: Neurological Conditions

PT OT Therapy Intake Form: Neurological Conditions 2025

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4.3 out of 5

63 votes

The document is a PT/OT Therapy Intake Form specifically designed for patients with neurological conditions. It outlines the necessary information required for non-urgent therapy requests, including patient and provider details, diagnosis codes, service types (physical and occupational therapy), and assessment measures. The form also includes sections for documenting the patient's condition, treatment history, and progress assessments related to various neurological disorders such as acquired brain injuries, Parkinson's disease, and spinal cord injuries.

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Click ‘Get Form’ to open the PT OT Therapy Intake Form: Neurological Conditions in the editor.
Begin by entering the patient's personal information, including First Name, Last Name, Date of Birth, and contact details. Ensure accuracy as this information is crucial for processing.
In the 'Provider' section, fill in the provider's details such as name, specialty, and contact information. This helps streamline communication between healthcare providers.
Next, indicate the type of service requested (Physical or Occupational Therapy) and specify if this is an initial or continuing care request. Provide relevant dates for evaluation and onset of condition.
Complete the 'Patient Reported/Standardized Assessment' section by selecting appropriate measures used to assess mobility and balance. Input scores for both initial and follow-up assessments.
Finally, review all entered information for completeness before submitting your form. Utilize our platform’s features to save your progress or share it directly with relevant parties.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (190 Votes)
2018	4.3 Satisfied (63 Votes)

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Which kind of conditions require neurological physiotherapy?

Stroke, Multiple Sclerosis (MS), Spinal Cord Injury and Parkinsons are common neurological conditions. It also includes conditions of the peripheral nervous system such as Guillain Barre Syndrome. Neurological conditions can have a devastating impact on the lives of the patients, family and friends.

How to become a neurological OT?

After obtaining your degree, you need to gain clinical experience before sitting for a certification exam from the National Board for Certification in Occupational Therapy (NBCOT). You then gain experience and take continuing education classes and board certification exams to specialize in neuro occupational therapy.

What is occupational therapy for neurological conditions?

Neuro occupational therapy consists of the following key techniques: Cognitive rehabilitation. Neuro rehab occupational therapy can help restore cognitive functioning following a brain injury, improving attention, focus or problem-solving capabilities. The patient can then use these skills when completing daily tasks.

What are some common physical therapy treatments for neurological disorders?

Treatment may include: Exercise to stretch, strengthen, and improve flexibility. Balance and gait training for fall prevention. Visual perceptual skills training. Techniques to improve motor control and reduce spasticity. Massage and other therapies to ease pain and stiffness. Equipment recommendations (canes, walkers, etc.)