Occupational Therapy Data Collection Form
Track measurable progress toward a goal session by session — trials, accuracy, cue level, and a progress summary. Free to download.
- 12 dated session rows with trials, correct, and percentage
- Standard cue-level key from independent to hand-over-hand
- Baseline, target, and progress summary sections
| Date | Trials | Correct | Cue | Sign |
|---|---|---|---|---|
| Sessions recorded | ||||
Objective data, session by session
The measurable evidence payers and progress reports depend on.
- Goal, baseline, target, and measurement method
- 12 dated session rows
- Trials, correct, and percentage columns
- Cue level key: I, V, VI, G, T, HOH
- Progress summary and plan
Who it’s for
Pediatric OTsSchool-based OTsCOTAs / OTAsABA-adjacent teamsClinic ownersIf you write goals with a criterion, this is how you prove you met it.
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.
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 →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 →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 →More for occupational therapy clinics
🧩 OT practice software
The full picture: scheduling, goals, documentation, authorizations, and billing built around occupational therapy.
See the OT platform →💳 OT billing
CPT-coded superbills, authorization and unit tracking, and pay type set per service — not per client.
Explore billing →📅 Therapy scheduling
Drag-to-book appointments, client self-scheduling, and reminders that keep your calendar full.
Explore scheduling →Reading for OT clinic owners
Form FAQ
How many sessions fit on one sheet?
Twelve dated rows, plus a notes area for continuation. For longer goals, print a second sheet and keep them together.
What do the cue-level abbreviations mean?
The key is printed on the form: I for independent, V verbal, VI visual, G gestural, T tactile, and HOH hand over hand.
How do I calculate the percentage column?
Correct trials divided by total trials for that session. Keeping trial counts consistent between sessions makes the trend far easier to read.
Can an OTA record the data?
Yes. There’s a signature line for the treating therapist and a second for the supervising OT where your state requires co-signature.
How does this help with progress reports?
It gives you objective numbers instead of impressions. Terapiq graphs the same data automatically and drops the trend straight into progress notes.
Grab the form — it’s on us
Free, fillable, and ready to brand. Download it now and see how much easier this can be.