New Client Forms
If you are a new client of InterPlay, please fill out the following forms prior to your first visit with us. InterPlay has two locations in Palm Beach County and caters clients from all over Palm Beach County; from Wellington, Boca Raton, West Palm Beach, Jupiter, and more.
Forms:
- History Record
- Information Release Form
- Notice of Privacy Act (HIPPA)
- Cancellation Policy
- Release and Waiver of Liability
- Credit Card on File Agreement
- Payment Policy
- Emergency Treatment Authorization
- Waiting Room Confidentiality Agreement
- Photo / Video Release Form
Completing ALL these forms BEFORE your first visit will ensure a fast intake on your apportionment day. We are honored you chose us to be part of your child’s future!
Testimonials
I drive from Boca Raton to West Palm Beach once a week for my son to receive Occupational Therapy at Interplay. Last year, his eyes were skipping over the middle of words and today he is reading on a second grade level! I see other children and families they work with and I know how well they are all being treated and cared for.