Patient Information

Patient Forms ▪ Referral Form ▪ Resources ▪ Insurance ▪ FAQ

If you have scheduled an evaluation for your child, you may print and complete the following forms to bring with you to your appointment. This will save you time at the clinic on the day of your appointment. If you have any questions regarding these forms, please call 918-663-0606 or email info@therapyworkstulsa.com.

New patients - download the following forms individually or download the entire new client packet.

Patient Information Form

Consent to Treat/Medical Records Release Form

Medication Record Form

Notice of Privacy Practices

Acknowledgment of Receipt of Privacy Practices

Payment and Insurance Policy

Photography/Videotaping Release

If you need to reschedule or cancel your child's appointment, please call or email schedule@therapyworkstulsa.com.

All forms are in Adobe Acrobat Reader format. You can download the latest free version here.