Occupational Therapy Pediatric Intake Form

What is an occupational therapy pediatric intake form?

An occupational therapy pediatric intake form is an important document that is used to record and assess the child’s existing condition of mental health, the challenges faced by the child, and desired goals with respect to their occupation and their daily routine. The form is used by an occupational therapist to understand the existing and past conditions of the child and devise a tailored therapy plan to improve their mental health. 

Why purpose does an occupational therapy pediatric intake form serve?

An occupational therapy pediatric intake form helps a therapist understand the challenges faced by the child in relation to their routine activities, and design a therapy that aligns with the child’s needs and preferences. The sole aim of the form is to inform the therapist about the child’s abilities and challenges and ensure that the devised therapy is safe and effective. This form acts as an important tool to help the therapist provide the best possible care to the child. 

What does an occupational therapy pediatric intake form contain?

An occupational therapy pediatric intake form includes the following: 

• Personal details such as name, date of birth
• Person completing the intake form and contact details
• Medical history 
• Family history
• Therapy history 
• Symptoms/challenges 
• Therapy goals 

Who needs to fill out an occupational therapy pediatric intake form?

Typically an occupational therapy pediatric intake form is filled out by the child’s parent or guardian, especially when the patient is a minor. The form is further completed by the occupational therapist, after conducting a thorough assessment of the child’s symptoms, medical history, and functional abilities. The therapist also records his observations post-therapy. The form can also be filled out electronically, in case the patient’s family wants the therapist to assess the case well in advance of the appointment. 

What are the legal requirements of an occupational therapy pediatric intake form? 

There lie several legal requirements for an occupational therapy pediatric intake form. These include

• The form should include a detailed explanation of the treatment being provided, along with risks and side effects, if any.
• The form should have the consent of the patient and their family to avoid any disputes later on.
• The form should be HIPAA-compliant.
• It must follow ethical standards and laws pertaining to the privacy and confidentiality of the patient’s information.
• The form must comply with record-keeping requirements such as medical billing and documentation. 

While these are some general guidelines, the form’s legal ramifications depend on the jurisdiction that it is used. Hence, it is advisable to consult with a legal professional before drafting the form.