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A form to be completed by new clients at the request of the evalutating/treating therapist.

Sensory Motor History Form (PDF)

This form requests the following types of information:

  • Family & Medical History

  • Developmental History

  • Sensory History

  • Speech Language History

  • School Information


These forms are provided in Adobe PDF format (Portable Document Format), which allows higher-quality print output. To open this file, you will need Adobe Reader software installed on your computer. If you do not have the Adobe Reader software already installed on your computer, you can download the installer and instructions for free at the Adobe Website.

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