Call or email us to discuss your child’s needs, our services and how to schedule an initial consultation for occupational therapy, speech or academic support and services.
DIRECTIONS: Each form is downloadable as a “zip” file. Once you download the zip file, open (unzip) it, and then open the PDF form. Simply input your responses, save the PDF and email the completed form to your therapist.
IMPORTANT: Save the PDF after you have input your responses & before emailing it to your therapist.
Download Occupational Therapy Intake Form
This form also includes Practices & Policies, Notice of Privacy Practices, and Credit Card Authorization Form).
Download Speech & Language Intake Form
This form also includes Practices & Policies, Notice of Privacy Practices, and Credit Card Authorization Form).
Other Forms
Form for Insurance Policy Holders (this form is only for those who are contracted for therapy services thru Kaiser or Meritage)
500 Tamal Plaza, Suite 525
Corte Madera, CA 94925
Little Hands is seeking skilled clinicians and administrators to join our team.
If you want to be a part of this creative group, please email your resume and cover letter to Gabrielle Perelmuter:
These camps will take place the weeks of July 15th and July 22nd. All groups will be facilitated by Pediatric Occupational Therapists.
The 3 camps we are offering this summer are: