Patient Forms

Our patient intake paperwork can be accessed from the links below. Please use the password provided to you by the office staff to open the documents.

Please make every effort to print and complete the forms before arriving for your child’s evaluation or first therapy session.  This will ensure that you have ample time at the clinic to complete any additional questionnaires and/or speak to the therapist performing the evaluation.

The intake packet can be found here: Village Therapy Works Intake Packet

The case history form can be found here: Village Therapy Works Case History Form


If you are seeking tutoring services only, the tutoring intake packet can be found here: Village Therapy Works Intake Packet (Tutoring)