Skip to content
Cultivate Rehab — A Nature Based Occupational Therapy Practice
  • Therapy Services
    • Clinic Based Therapy
    • In-Home OT
    • Hippotherapy
  • Therapeutic Adaptive Riding
  • Summer Programming
  • About Us
  • Contact
    • Forms

Forms

New Patient Paperwork

For OT utilizing hippotherapy and therapeutic riding Cultivate Rehab requires this medical form to be filled out by your child’s doctor once per year. https://cultivaterehab.com/wp-content/uploads/2024/07/Medical-History-and-Physician-Statement-GS.pdf

For new patients referral form– a new referral is needed once a year.

We keep a credit card on file which we charge for payments that are more than 90 days past due. Credit Card Authorization Form.

About Us Forms

©️ 2026 Cultivate Rehabilitation Services LLC

  • Facebook
  • Instagram

Sign up for our mailing list

Thank you!

You have successfully joined our subscriber list.