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Sensory Kids Occupational Therapy

Portland Occupational Therapy Clinic for Kids

Online Sessions Available Now!  Pediatric Inquiry and Registration Adult Inquiry and Registration

  • COVID-19
  • About
    • Our Philosophy
    • Our Team
    • Our Policies
    • Sensory KIDS Social Justice Statement
    • FAQs
    • Praise
    • Volunteer Intern Opportunities
    • Employment Opportunities
  • Intake Process and Forms
  • Services
    • Adults & Adolescents
    • Infants & Toddlers
    • Autism
    • Intensive Treatments
    • Online Services
  • Resources
    • What is SPD?
  • Events
    • Learning Connections: Webinar Series
    • A SECRET Care-Giver Training Online Workshops
    • Live Online Q&A

Patient History Form – Adult

Directions for History Form – Adult

Please complete the forms to the best of your ability. Mark “n/a” for any information that is not applicable to your child.

Adult History Form

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Find Us

1425 N Killingsworth St
Portland, OR 97217 | Map

P: 503-575-9402
F: 888-769-4431
info@sensorykidsot.com

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Portland Occupational & Sensory Therapy for Children | Sensory Kids Portland | Website Design by SimplyFine Design | Photography by Bill Purcell