If you have not already done so, please fill out this short form to start the process to schedule your initial session. This will help ensure that Farfalla Integrative Health is an appropriate OT provider for your specific needs. If you’ve already filled out the form, thank you; you don’t need to do it again.
You must have a prescription for occupational therapy to schedule an occupational therapy evaluation or an initial myofascial release session. If you don’t have a prescription yet, ask your doctor’s office to fax/e-fax one directly to Farfalla Integrative Health. Our fax number is 866-284-0293.
All prescriptions must include the following:
- Your name and date of birth
- The words “Occupational therapy – Evaluate and treat“
- At least one diagnosis AND the appropriate diagnosis code (ICD code)
- Your doctor’s signature and the date the prescription was signed.
If you already have a prescription, please email christine@farfallaintegrativehealth.com and let us know. We will follow up with you to make sure the prescription includes all the necessary information.
Once the prescription is taken care of, please complete the following steps in order. All forms are completed online and don’t need to be printed out. Click on the blue links to access each form.
- Read and sign the Informed Consent and Client Agreement form. (In addition, the law requires us to provide you with Farfalla Integrative Health’s Notice of Privacy Practices. The privacy notice doesn’t have to be signed, but if you’d like to print one out for your reference, use this printable version.)
- If you’re coming in for myofascial release services, please read and sign the Informed Consent for In-Person Acupressure and Myofascial Release Sessions. If myofascial release is not your primary reason for your OT evaluation, just skip this step.
- Fill out the intake form.
- Fill out the release of information form so I can communicate with your doctor and any other healthcare providers or family members you wish to specify.
- Schedule and pay for the initial appointment. (If you prefer not to schedule or pay online, contact me so we can make other arrangements.) Choose only ONE option below:
- On-site visit (e.g., at your home or workplace) – If you are interested in an on-site initial OT visit, we’ll need to set something up by phone. On-site visits may incur additional costs depending on your location. Please email me some times when you’ll be available to talk for a few minutes so we can work out the financial details and schedule the evaluation if you’re still okay with the price. Once we have the appointment set up, I’ll email you a payment link. Payment is due before the start of the session.
Schedule and pay for a session.
If you have questions, you can either set up a brief phone or video call or email me at christine@farfallaintegrativehealth.com
If you prefer not to schedule or pay online, contact me so we can make other arrangements.
Schedule and pay for a session.
If you have questions, you can either set up a brief phone or video call or email me at christine@farfallaintegrativehealth.com.
If you prefer not to schedule or pay online, contact me so we can make other arrangements.