Every occupational therapist knows that a thorough initial evaluation is the foundation of effective treatment. This Occupational Therapy Initial Evaluation Form template helps you gather comprehensive patient information about daily living activities, workplace needs, and hand function—all in one professional, easy-to-complete form.
This template is designed specifically for occupational therapists working with patients who need support with activities of daily living (ADLs), workplace accommodations, or hand function rehabilitation. Whether you're treating stroke survivors, workplace injury cases, or patients with chronic conditions affecting their independence, this form captures the essential baseline data you need.
The form guides patients through a structured assessment of their current functional abilities, pain levels, and specific challenges they face in daily tasks. By collecting this information upfront, you can spend your first session focusing on hands-on evaluation and building rapport rather than paperwork.
With Paperform, you can customize this template to match your practice's branding and embed it directly on your website or send it to new patients via email before their first appointment. Conditional logic ensures patients only see relevant questions based on their primary concerns—keeping the form streamlined while capturing detailed information.
Submissions flow directly into your practice management system through Paperform's integrations, or you can route them to Google Sheets, Airtable, or your CRM. Set up automated confirmation emails with pre-appointment instructions, and use Stepper to trigger follow-up workflows like insurance verification or chart preparation.
For practices handling sensitive patient data, Paperform offers SOC 2 Type II compliance and robust security features. While this template is not HIPAA compliant, it's designed for the pre-appointment data collection many OT practices need to optimize their intake process.
Whether you work in an outpatient clinic, hand therapy center, workplace rehabilitation program, or private practice, this template adapts to your specific patient population. Occupational therapists, OT assistants, and practice managers will find this form helps standardize your intake process while still allowing room for individualized care planning.
Start using this template today to reduce administrative burden, improve your first-session efficiency, and provide better patient experiences from the very first touchpoint.
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