Welcome to Special Therapies, Inc. Our New Patient forms are found below. Please print and complete each form in the “New Patient forms” section. In addition, please print and complete the forms listed under the specific service you will be receiving through Special Therapies. We appreciate your time in completing these forms prior to your appointment. The forms can be returned via mail, e-mail, fax or personal delivery.
New Patient forms:
- New Patient Registration Form for ST Website
- Insurance Claim Submission Form for ST Website
- HIPAA Guidelines for ST Website
- HIPAA Acknowledgement for ST Website
Craniosacral Therapy forms:
Occupational Therapy/Sensory Integration forms:
- Sensory Motor History OT for ST Website (All new patients)
- Sensory Profile Questionnaire — Infant & Toddler ST Website (Birth to 6 months)
- Sensory Profile Questionnaire — Infant & Toddler ST Website (7 months to 3 years)
- Sensory Profile Questionnaire — Caregiver (3 to 17 years old)
- Sensory Profile Questionnaire — Adolescent & Adult
Note: Your therapist may request additional forms when you come in the first time.