top of page

Intake Paperwork for New Clients

Listed below are the four (4) REQUIRED intake forms for new clients.

 

Click on the PDF image to the left of the form name to digitally fill out each form. You are also welcome to print and scan. Once all forms are completed, please email them before your first scheduled intake session.

Policies and Procedures

This form details all relevant policies and procedures regarding Educational Therapy sessions. Assuring we are aligned with approach and logistics streamlines communication. Feel free to reach out with any questions.

Client Background Data

This form provides detailed and relevant information about your child's biographical, psycho-educational, emotional, social, and medical history so that sessions may be tailored to achieve optimtal success and provide the appropriate background information to leverage strengths and overcome challenges.

Executive Function Baseline

This form provides a baseline of YOUR perspective of your child's executive function skills. This is meant to be filled out from the parental perspective.  We will engage in a similar activity in session from your child's perspective. 

Release of Information

This form provides the legal ability to collaborate with your child's school-based and external allied professional team. Educational therapy embraces the opportunity for an educational therapist to serve as a case manager in order to assure that all relevant professionals are collaborating with messaging and approach, as best as possible.

bottom of page