Screens | First Priority OT

Preschool Screens

Thank you for your interest in signing up your student for an occupational therapy (OT) screen with First Priority Occupational Therapy! Since these screenings are to take place during the school day, caregivers do not need to be present for the screening. The recommendations and observations made during the OT screen will be sent to the email address below within one week of the screening. The cost of the screens are $35.

Yes

I give permission for my child to participate in an occupational therapy (OT) screen offered by First Priority Occupational Therapy, LLC. I understand that the occupational therapy screening will take place by a licensed occupational therapist or occupational therapist assistant during my child’s school day. I understand that the screen may consist of a combination of classroom observation, teacher input, and/or direct student participation in developmental activities for a holistic screening perspective.

Child's Name:

Child's DOB:

Month

Day

Year

Child's Age:

Child's Group/Days at School:

Caregiver/Parent's Name:

Caregiver/Parent's Phone:

Caregiver/Parent's Email:

Home Address:

Please list caregiver/parent and/or teacher observations and concerns: