Forms

Please complete and send in forms 48 hrs before your appointment so your therapist can best prepare for your child.

STEP 1. Please complete intake & consent for ALL new patient appointments:

Online fillable New Patient Intake and Consents: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=19604

Or use this printable form: New Patient Form

New Patient information Video

STEP 2. Please complete one of the following pre-exam forms for EACH Specialist that your child will see:

*SPEECH Online fillable Pre-Exam Form: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12103

(Or use this printable form: Speech & Language )

*OT FEEDING Online fillable Pre-Exam Form: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12115

(Or use these printable forms: OT- Feeding & Oral Motor Three Day Diet History )

*OT FINE Motor/Sensory Online fillable Pre-exam form: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12122

(Or use this printable form: OT – Handwriting & Sensory )

*PT (Developmental/Torticollis/Gross Motor: Online fillable Pre-Exam Form for PT : https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12105

(Or use this printable form: PT – Developmental/Torticollis & Gross Motor )

*PT Injury/Orthopaedic care: Online fillable Pre-Exam form: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12023

(Or use this printable form: PT-Injury/Orthopaedic )

STEP 3. If you are using CalOptima insurance, and your child is 3 yrs or older, please complete this form:

IEP Notice: https://www.digitalintakes.com/practices/1185/patients/1/public_url?active_loc=all&form_id=12120

Financial Assistance:

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Scholarship Application