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FORMS

 

 

Occupational Therapy

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Background Information and Occupational Intake Form

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Privacy Information and Consent to Treat Form

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Photo Release Form

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Irlen Clinic

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Welcome To Our Clinic

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Self-Test Form

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Academic Skills Form (For Students)

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Teacher Observation Form (For Students)

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

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

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

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