• Request an Appointment Contact Me

    info@ntrlink.com | 844-NTR-LINK

    • Facebook
    • Pinterest
    • Twitter
  • National TeleTherapy Resources

    • Home
      • Testimonials
      • Frequent Questions
      • About Us
    • Services
      • Speech-Language Therapy
      • Occupational Therapy
      • Behavior Therapy
      • Mental Health Services
      • American Sign Language Interpretation
      • Enrichment Services
      • Interested in Joining the NTR Team?
    • Resources
      • TeleTherapy: Supported by Research
      • TeleTherapy: Supported by National Organizations
      • TeleTherapy: Stay Current, Know the Laws and Policies
    • Therapist Login
    • Student Login
    • Schools
    • Client Forms
    • Blog

    Client Forms

    If you are signing your student up for one of our Enrichment Programs, please complete the following form and submit it with your application:

    Enrichment Class – Liability Release

    If you are seeking therapy services with one of NTR’s occupational or speech therapists, download and fill out either the child or adolescent intake form as well as the authorization for release of information.

     

    Child Intake

    Adolescent Intake

    Authorization for Release of Information

    National TeleTherapy Resources, LLC

    info@ntrlink.com
    844-NTR-LINK
    By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.
    • Facebook
    • Pinterest
    • Twitter
    A Website by Brighter Vision | Privacy Policy