Intake Template for Occupational Therapy

A while back, I posted an article about “5 key considerations when moving from employee to your own private practice”. While I wish there were only 5, there are actually more. Having a general idea of your process and templates for being an occupational therapist is so important. To name a few; invoicing, consent, intake, documentation and summary reports.

A few weeks ago, we talked about invoicing, how to make sure you get paid on time, and I shared with you the occupational therapy invoice template I used for several years before adopting Therabyte. As a part 2 to that blog post, today we’re going to talk about how to create an occupational therapy intake form, what information you should share, and what questions you should ask!

While my own specialization is in pediatrics, this occupational therapy intake template will help you get started and create a tailored, personalized version that will fit your own specialization!

  1. Basic information about the services you offer – Depending on how you are going to deliver this occupational therapy intake form to your clients they may still be learning about what Occupational Therapy is and how it can specifically support them at this time in their life. So tell them a bit about what you offer and how they will benefit.
  2. Client’s basic information Name, phone, address, age, PHN, etc. Any details you will need to have to provide your services to them. 
  3. Previous medical history or therapies Any surgeries, diagnosis or previous therapies that would be relevant to their current need for services. 
  4. Strengths and current skills – I love this question, because so often therapy can focus on the deficit and this gives a chance to get to know the strengths of your new client and how you can use that to support them in occupational therapy.
  5. Mobility – Do they require an aide?
  6. Areas of concern – What is their reason for connecting with you? What area of support do they need? Here you might want to include a list of the services you provide and get them to check them off. 
  7. Order of Priority – I love using a table similar to the COPM, to have them rank their priority areas, it gives a nice place to come back to later to review how therapy has supported client growth since that initial occupational therapy intake form. 

You got into your profession to help others, not to get lost in completing non-billable tasks. Here’s the occupational therapy intake form template for you, accessible below, so that you can solve the admin challenges of your business and get back to doing what you love!

And while this occupational therapy intake form template worked for the first few years of my career, as my private practice grew I found the need to automate and centralize all of my documents! I have adapted that information within my Therabyte workflow between my website and client self intake. As you can probably tell, I’m a huge advocate of automation and while templates can help you get started, when you’re ready to jump to the next level, Therabyte can automate the intake process for you!




Looking forward to connecting soon, please reach out with any comments or questions at

 Ashley Reina,

Occupational Therapist & Co-founder of Therabyte App

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