Registration & Forms

After scheduling your initial appointment, forms can be filled out and submitted digitally for your convenience.

Registration & Forms

Notice of Privacy Practices

Patient Service Agreement - *NOTE: This document is on the website for information/reference purposes only. Clients are to sign this form with a Therapy Associates employee during their initial visit.

Occupational Therapy Patients:

Patient/Client Registration Form

Online Form or Downloadable PDF

Child Therapy Case History Form

Online Form or Downloadable PDF

Speech Therapy Patients:

Patient/Client Registration Form

Online Form or Downloadable PDF

Child Therapy Case History Form

Online Form or Downloadable PDF

Myofunctional Therapy Patients:

Patient/Client Registration Form

Online Form or Downloadable PDF

Orofacial Myology History Form

Online Form

Feeding Program Patients:

Feeding Program Intake Form

Online Form or Downloadable PDF

Feeding History Form (Age 2 & Under)

Online Form or Downloadable PDF

Feeding History Form (Over Age 2)

Downloadable PDF

Tube Feedings

Downloadable PDF

Food Journal - Download Only

Downloadable PDF

Feeding Evaluation Instructions

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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