Occupational Therapy Questionnaire

  • Occupational Therapy Questionnaire

  • Self-Care Tasks

    Dressing
  • Shoes on*
  • Shoes off*
  • Shirt on*
  • Shirt off*
  • Pants on*
  • Pants off*
  • Socks on*
  • Socks off*
  • Bathing*
  • Toileting*
  • Brushing Teeth*
  • Brushing Hair*
  • Nail Clipping*

  • Play Skills

  • Does your child initiate play with others?*
  • Does your child share?*
  • Can your child take turns?*
  • Should be Empty: