Forms ptot 2026

1. Click ‘Get Form’ to open the PT/OT Initial Evaluation Report in the editor.
2. Begin by entering today's date at the top of the form. This helps establish a timeline for the evaluation.
3. Fill in the insurance company name, patient details including name and ID number, and date of birth or age. Accurate information is crucial for processing.
4. Document the date of injury and surgery if applicable, along with relevant ICD-9 codes and diagnosis to ensure proper categorization.
5. Complete the referring physician's information, including their ID number, to maintain clear communication channels.
6. In the 'Objective Findings' section, assess strength and motion. Indicate whether it’s PT or OT and specify the involved region.
7. Detail how and where the injury occurred, noting if it was work-related. Include pertinent history and pain assessment using a scale from 0 to 10.
8. Outline functional deficits, treatment plans, goals, and projected frequency/duration of treatment before signing off as a therapist.

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