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FORMS

 

 

Occupational Therapy

Background Information and Occupational Intake Form

Privacy Information and Consent to Treat Form

Photo Release Form

Irlen Clinic

Welcome To Our Clinic

Self-Test Form

Academic Skills Form (For Students)

Teacher Observation Form (For Students)

Buckeye Therapy Services, LLC  3643 Dill Rd, Centerburg, Ohio 43011  

 Phone:  614-602-9394, Email: lhall@buckeyetherapy.com

(Copyright © 1998-2025 by Perceptual Development Corp/Helen Irlen.  All rights reserved.)

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