Registration & Forms

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.

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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

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‍Speech Therapy Patients:

‍Patient Registration Form

Online Form or Downloadable PDF

‍Child Case History Form

Online Form or Downloadable PDF

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Myofunctional Therapy Patients:

Patient Registration Form

Online Form or Downloadable PDF

Orofacial Myology History Form

Online Form or Downloadable PDF

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‍Feeding Program Patients:

Feeding History Form (Age 2 & Under)

Online Form or Downloadable PDF

Feeding History Form (Over Age 2)

Online Form or Downloadable PDF

Tube Feedings

Online Form or Downloadable PDF

‍Food Journal - Download Only

Online Form or Downloadable PDF

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Feeding Evaluation Instructions

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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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