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● Free download · Fillable PDF

Occupational Therapy Activity Analysis Form

Break any activity into its demands, steps, and required client factors — the structured worksheet OT students and clinicians use for activity and performance analysis. Free to download.

  • Step-by-step task breakdown with required body functions
  • Performance skills, patterns, and context prompts
  • Grading up / grading down columns for adaptation
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Activity Analysis Worksheet
Occupational Therapy — Activity Analysis
Activity
Client / group
Completed by
Date
StepDemandBody functionGradeSign
Steps analyzed 
Free template provided by Terapiq · terapiqcrm.com
What’s inside

A complete activity analysis, step by step

Structured the way OT curricula and practice frameworks teach it — so nothing gets skipped.

  • Numbered task steps with observable demands
  • Required body functions and performance skills
  • Context, objects, and space requirements
  • Grading up and grading down suggestions
  • Space for safety and precaution notes

Who it’s for

OT studentsFieldwork educatorsPediatric OTsRehab teamsClinic owners

Whether you’re learning activity analysis or documenting it for a client’s plan, this worksheet keeps your thinking organized.

From paper to effortless

Love the form? You’ll love not needing it.

The template is great on paper. Terapiq does the same job digitally — no lost sheets, no manual tallies, no chasing signatures.

Capture it in seconds

Fill it in from any device — Terapiq handles the totals, dates, and formatting automatically.

Signatures & audit trail

Sign-offs, dates, and details are captured and time-stamped — ready whenever someone asks.

One place for your clinic

Forms live alongside scheduling, notes, and billing — not in a folder of loose PDFs.

The software in action

One platform, the whole clinic

This form is just the start. Here’s what else stops being paperwork.

Book in one drag

Click-and-drag appointments, online self-scheduling, and automatic reminders that cut no-shows — across every therapist, room, and location.

Explore scheduling →
Wednesday · Room 2
9:00OT eval
10:30Group
1:00Peds OT

Notes that draft themselves

Document during the session and let the note assemble itself — goals, minutes, and CPT codes included. Review, sign, done.

See OT documentation →
Session note · Olivia S.
Goal: bilateral coordinationOn track
Auto-drafted from sessionReady to sign

The note becomes the bill

CPT-coded superbills straight from your documentation, live authorization tracking, and self-pay or insurance set per service.

Explore OT billing →
Superbill · ready to send
97165 · Evaluation$120
97530 · Ther. activities$80
Total$200
Questions

Form FAQ

What’s the difference between activity analysis and occupational analysis?

Activity analysis looks at the demands of an activity in general. Occupational analysis looks at what that activity demands of a specific client in their context. This worksheet supports both — add the client details when you’re analysing for one person.

How detailed should each step be?

Detailed enough that another therapist could follow it. One observable action per row usually works best — “grasp button” rather than “get dressed.”

Can I use this for coursework?

Yes, and many students do. Fieldwork educators are welcome to hand it out as a standard template for the whole cohort.

Does it cover performance analysis too?

Yes. The same structure works when you’re analysing how a client performs an activity, not just the activity itself.

Do I have to redo this for every client?

On paper, usually yes. In Terapiq you save an analysis once, then link it to any client’s goals and session plans — so a common activity is only broken down a single time.

Grab the form — it’s on us

Free, fillable, and ready to brand. Download it now and see how much easier this can be.