Everyone Must Complete:

• Acknowledgement of Receipt of Privacy Practices & Authorization and Release Form
• Notice of Privacy Practices
• Authorization for Photography and Recording
• COVID-19 Pandemic Notice & Acknowledgment of Risk Form
• Authorization and Consent to Participate in Telehealth

If Private Pay or Insurance Must Complete:

• Credit Card Authorization Form
• Financial and Office Policies

If Insurance Must Complete

• Insurance Intake Form

If Regional Center Must Complete:

• Regional Center Credit Card Authorization Form
• Regional Center Financial and Office Policies

Intakes by Discipline:

• Occupational Therapy Intake (OT Intake)
• Physical Therapy Intake
• Physical Therapy Intake (Birth – 12 months)
• Speech Therapy Intake for children OVER age 1
• Speech Therapy Intake for children UNDER 1