Forms to be Completed

To ensure we have all the necessary information to provide the best possible care, clients will be required to complete several forms during the intake and enrollment process. These forms include:

• Personal Information Form
• Medical History Form
• Consent for Treatment Form
• Insurance Information Form
• Privacy Policy Acknowledgment
• Speech, Occupational & Physical Therapy Intake Form
• Habilitation/Respite Intake Form
• Pre-Service Provider Orientation
• Other – Depending Upon Services Being Sought

Our team will be available to assist clients with any questions or concerns they may have while completing these forms.