Registration & Forms

Registration & Forms

‍Notice of Privacy Practices Form

Patient Service Agreement - Form - *NOTE: This form is on the website for information/reference purposes. Clients are to sign this form ONLY at the office with a Therapy Associates employee.

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Occupational Therapy Patients:

‍Patient/Client Registration Form

Online Form or Downloadable PDF

‍Child Case History Form

Online Form or Downloadable PDF

‍Sensory History Form

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‍Speech Therapy Patients:

‍Patient/Client Registration Form

Online Form or Downloadable PDF

‍Child Case History Form

Online Form or Downloadable PDF

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Myofunctional Therapy Patients:

Patient/Client Registration Form

Online Form or Downloadable PDF

Myofunctional Case History Form

Orofacial Myology Case History

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‍Feeding Forms

Feeding Program Intake Form

Online Form or Downloadable PDF

Feeding History Form (Age 2 & Under)

Online Form or Downloadable PDF

Feeding History Form 3+ Years Old‍

Tube Feeding Form

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‍Feeding Evaluation Instructions

‍Feeding Journal

Food Journal - 3 Day - Download only

Other Forms

Authorization For the Release of Information Form

Online Form or Downloadable PDF

Health Insurance Benefits Worksheet

Online Form or Downloadable PDF

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