Get the free REFERRAL FOR PHYSICAL/OCCUPATIONAL THERAPY template

GILES COUNTY SCHOOLS REFERRAL FOR PHYSICAL/OCCUPATIONAL THERAPY SCHOOL YEAR NEW RENEWAL Students Name: Date of Birth Parent/Guardian: School: Address: Therapist: Date: Permission is given for my child

How to fill out referral for physicaloccupational formrapy

How to fill out referral for physicaloccupational formrapy

1. To fill out a referral for physical or occupational therapy, follow these steps:
2. Obtain the referral form: Contact your healthcare provider, such as your primary care doctor or specialist, to request a referral form for physical or occupational therapy. They may provide you with a physical copy or a digital form.
3. Complete personal information: Fill out your personal information on the referral form. This typically includes your full name, date of birth, contact information, and insurance details.
4. Specify therapy type: Indicate whether you are seeking physical therapy or occupational therapy, or both, by checking the appropriate box or providing the necessary information.
5. Provide relevant medical history: Provide information about your medical history that is relevant to the therapy you are seeking. This may include previous injuries, surgeries, or any other conditions that may impact your therapy treatment.
6. Include healthcare provider details: Fill in the details of the healthcare provider who is referring you for therapy. This may include their name, contact information, and their professional credentials.
7. Add any additional notes: If there are any specific concerns or requests you have regarding your therapy, you can include them in the additional notes section.
8. Sign and date the form: Ensure you sign and date the referral form to indicate your consent and agreement with the information provided.
9. Submit the referral form: Once you have completed the referral form, submit it to the designated recipient. This may be the physical or occupational therapy clinic you wish to visit or your insurance provider, depending on their specific requirements.
10. Always follow any additional instructions provided by your healthcare provider or the therapy clinic to ensure a smooth referral process.

Who needs referral for physicaloccupational formrapy?

1. Referral for physical or occupational therapy may be required for individuals who:
2. - Have recently undergone surgery and require rehabilitation
3. - Are dealing with muscle or joint pain or injuries
4. - Have neurological conditions, such as stroke or multiple sclerosis
5. - Have chronic or long-term conditions affecting their physical abilities
6. - Require assistance with regaining mobility and function
7. - Are seeking therapy as part of their overall care plan recommended by their healthcare provider
8. It is important to consult with your healthcare provider to determine if a referral is necessary in your specific case. They will assess your condition and recommend the appropriate course of action.

What is REFERRAL FOR PHYSICAL/OCCUPATIONAL THERAPY Form?

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Instructions for the REFERRAL FOR PHYSICAL/OCCUPATIONAL THERAPY form

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