Columbia Peds Therapy
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    • Initial Contact Form
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  • Services
    • Speech Sounds
    • Oromyofunctional Therapy
    • Language
    • Augmentative Communication
    • Feeding Therapy
    • Breast/Bottle Feeding
    • Occupational Therapy
    • Online Therapy
  • For Families
    • First Visit
    • Forms
    • Insurance
    • Informational Handouts
  • Blog
  • Home
  • About Us
    • Meet Our Team
    • Photos
    • Employment
  • Contact
    • Initial Contact Form
    • Referrals
  • Services
    • Speech Sounds
    • Oromyofunctional Therapy
    • Language
    • Augmentative Communication
    • Feeding Therapy
    • Breast/Bottle Feeding
    • Occupational Therapy
    • Online Therapy
  • For Families
    • First Visit
    • Forms
    • Insurance
    • Informational Handouts
  • Blog

Forms


New Client Forms

Please fill out the following forms before coming in for your evaluation.  Click on the links below to fill out each form:

​Client Intake Form - Speech Therapy
Client Intake Form - Occupational Therapy

This is our initial client intake form that we require for all new clients.  It helps us get to know your child better prior to the evaluation in order to maximize our evaluation time.

Sickness Waiver Form

This form is a ​Waiver of Liability Relating to Coronavirus/COVID-19.

Release Forms

Forms including: photo/video release form, student observation and treatment release form, and activity liability release form.

Parent Signature Forms

These forms include Attendance, Consent for Services, and Privacy Policy.

​​​Consent for Release of Medical Information

We may use the exchange of information form if we are needing to collaborate with other service providers regarding your child's care. If you already know of a provider who would like a copy of your child's information, please feel free to it fill out for that provider.  Your child's health information is protected and will not be shared without your consent.

Online Therapy Form

Prior to beginning online therapy with us, please fill out the Teletherapy consent form below.
Teletherapy Form

info@columbiapedstherapy.com
16703 SE McGillivray Blvd
Suite 170
Vancouver, WA 98683

Phone: (360) 989-7347
Fax: 888-974-0252
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