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Occupational Therapy Request for Student Assistance *This is not considered a request for a specialized evaluation* Student: ___ Birthdate: ___ Grade/Placement: ___Date:___ Person Submitting the Request:___Home
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01
Gather all necessary information such as personal details, medical history, insurance information, and reason for seeking therapy.
02
Complete all sections accurately and to the best of your knowledge.
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Review the form for any errors or missing information before submission.
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Submit the form to the appropriate healthcare provider or therapy center.

Who needs occupational and physical formrapy?

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Individuals who have experienced injuries or disabilities that require rehabilitation through occupational and physical therapy.
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Those seeking to improve their functional abilities and independence in daily activities.
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Patients recovering from surgeries or medical procedures that affect mobility or strength.
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People with chronic conditions such as arthritis, stroke, or Parkinson's disease who can benefit from therapy interventions.

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Occupational and physical therapy is a type of rehabilitative care that focuses on improving a person's physical abilities and independence.
Individuals who are seeking treatment for physical or occupational injuries are required to file occupational and physical therapy forms.
To fill out occupational and physical therapy forms, individuals must provide information about their medical history, current symptoms, and treatment goals.
The purpose of occupational and physical therapy is to help individuals regain functional abilities and improve their quality of life.
Information such as medical history, current symptoms, treatment goals, and progress must be reported on occupational and physical therapy forms.
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