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Appointments

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Documents

Overview

All of us here at Boston Sensory Solutions, Inc. look forward to working closely with your family to provide individualized evaluation and treatment for you or your child. Prior to making an initial appointment, we do require that you complete our full intake packet.

You may complete the forms online, download the forms, or call our office to request copies be sent to you. Once we have your completed intake packet, our occupational therapists will review it carefully in order to best match for you or your child to one of our skilled clinicians. Finally, clinic manager will call you to discuss available appointment times and schedule your session.

We look forward to getting to know you and your family soon!

Online Forms and  Email/Internet Privacy Notice:

All of our on-line forms are created and kept secure via G-Suite, with whom we have signed a HIPAA Business Associate Agreement.  If you would like to read more about how G-Suite keeps your information private and secure, please refer to this page.

While unlikely, I accept that a breach of my privacy could occur when sending this information over the internet and/or when communicating by email and I am willing to accept that risk. I also understand that I have the option of printing this form and faxing it in or calling the office. For information on how we protect your privacy, please click here to view our privacy policy.

Alternatively, you may print individual or all intake form PDF’s and fax to (617) 507-0457‬.

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Client Intake Forms

Pediatric Occupational Therapy

Required Form
Client Demographic Form
Consent Form
Child OT Intake

Parent Forms

Required Form
Client Demographic Form
Parent OT Intake
Adult Consent Form

Adult Occupational Therapy

Required Form
Client Demographic Form
Adult OT Intake
Adult Consent Form

Safe and Sound Remote Clients

Required Form
SSP Client Demographics Form

Medical Release of Information Form

Form

Notice of Good Faith Estimate

Form

Participation Form

Form

Practice Policies

General Policies

The On site Patient Care policy can be found here.

https://bostonsensorysolutions.com/documents/hipaa-notice-of-privacy-practicies/

A copy of our weather policy can be found here.

A copy of our cancellation policy can be found here.

A copy of our parent participation policy can be found here.

A copy of our food policy can be found here.

Insurance

We are in-network with the following insurance plans and are happy to work with families to request reimbursement for out-of-network services.
Harvard-Pilgrim
United Health Care and Harvard Pilgrim
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Mass-general-brigham-health-plan
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