Functional Independence Review form (for Provider use only)


For occupational therapists – when requested by us, complete these forms to review the functional capacity of a client, such as the physical, cognitive and emotional functioning, as well as communication skills, and to evaluate their progress toward increased independence.

For help completing this form, see the separate notes document.

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. Please email forms or other documents to and include the client's claim number in the subject line.