Parent Interview Questionnaire for Therapy


This parent interview questionnaire can be used in any setting during intake or OT evaluation of a client. Includes all the important fields like birth/family history, developmental history, self-care routine, and any additional concerns.

Streamline the occupational therapy evaluation process with a done-for-you interview.

This is a digital file that opens to an editable document on your Google Drive account.


The Parent Interview Questionnaire is a digital product. You will receive an email after purchase delivering a PDF which opens an editable document on your Google Drive. Work in the document to add background information on new clients prior to occupational therapy evaluation or intervention. Edit the file as you see fit to meet your documentation needs.

This editable document opens in your Google Drive account. Create a master copy and then make a copy for each new referral to streamline the screening and evaluation process. Send a copy to parents/guardians to allow information to be added right into the file.

The parent Interview Questionnaire is done for you so all you need to do is enter demographic information and send it off to request parent/guardian permission prior to occupational therapy screenings. You can also work right in the document while in the occupational therapy evaluation.

This Parent interview Questionnaire includes:

  • Demographic information
  • Background information
  • Family information for easily contacting family
  • Family history
  • Information about hand dominance in family
  • Therapy history
  • Health history
  • Developmental history
  • Strengths and interests to facilitate motivating and meaningful therapy interventions
  • Primary concerns
  • Self-Care/Daily Routines
  • Behavioral concerns
  • Transitions
  • Attention concerns
  • Sensory considerations
  • Motor skill considerations
  • Handwriting considerations
  • Academic considerations
  • Desired outcomes

Use this form to streamline the evaluation process and facilitate goal establishment with parental/guardian input.