Use this referral checklist to quickly gather information about OT-related concerns that a teacher may have about a student. The teacher's responses will help you determine how you will proceed with a screening or evaluation.

This referral checklist includes a wide range of concerns the teacher may have about a student. It includes items related to prewriting, handwriting, cutting, managing personal and classroom items, computer use, visual perceptual and motor skills, sensory processing, gross motor skills, and executive function.

When filling out this checklist, the teacher needs to consider whether the form item involves a skill that is expected or performed in the student’s classroom or school environment and whether the student is performing this skill at a level that’s comparable to his/her peers.

Last updated: June 2024

For the Google Form version of this referral checklist, click here.

How can I earn TPT credits to use on future purchases?

Go to your My Purchases page and click on the "Leave a review" link of the resource you purchased. Rate and comment on the resource. When you leave a review, TPT gives you credits that you can use for your future purchases.