Intake Forms

The following forms will help us know more about you. To start the process at COTI we must receive the Client Information Form and the Questionnaire that pertains to the age of the person who may receive services. There are two versions of each form provided below. The Word document can be filled out on your computer and then emailed to our office. Please email the forms to coti@cintiotinstitute.com. The PDF version can be printed off, completed, and faxed (513-791-0023) or mailed to our Blue Ash office. Once we have received your paperwork, we will call you when a time slot that matches your availability becomes open.

 

Paperwork for Children

Client Information Form

Client Information Form

Birth-2 Questionnaire

Birth-2 Questionnaire

3-5 year old Questionnaire

3-5 year old Questionnaire

School age Questionnaire 

School age Questionnaire

Handwriting Questionnaire

Handwriting Questionnaire

Food Inventory

Food Inventory

 

Paperwork for Adults

Client Information Form- Adult

Client Information Form- Adult

Adult Questionnaire

Adult Questionnaire