Full OT Functional capacity assessment (FCA) - Template + example

OT Functional Capacity Assessment Template + Full Report Example

 

A comprehensive OT Functional Capacity Assessment template and full de-identified report example to help occupational therapists structure clear, clinically reasoned and professional FCA reports.

 

Writing a Functional Capacity Assessment can be one of the most time consuming parts of occupational therapy practice. Knowing what information to include, how to structure the report and how to clearly connect assessment findings with functional impact and recommendations can take considerable time - particularly when requirements and expectations continue to evolve.

 

This OT Functional Capacity Assessment Template provides a practical framework to help you structure your report while reducing the time spent starting from a blank document.

 

This resource includes:

• A comprehensive Functional Capacity Assessment report template
• A full de-identified completed report example
• Clear report headings and subheadings
• Practical examples of how information can be presented
• Guidance around structuring clinical information
• Examples of linking assessment findings with functional impact
• Detailed recommendation examples
• Guidance around referencing evidence-based practice
• A practical, real-world example of how an FCA can be structured

 

The example report has been updated to reflect changes current as of March 2026, including changes associated with Section 33.

 

Who is this template for?

This resource has been developed primarily for occupational therapists completing Functional Capacity Assessments within the NDIS environment.

It may be particularly useful for:

• Occupational therapists new to completing FCAs
• OT's transitioning into private practice
• Therapists wanting to review or improve their existing FCA structure
• Experienced clinicians looking for a comprehensive reference example
• Therapists wanting to improve the clarity and consistency of their reports

 

Every client is different, and an FCA needs to reflect the individual circumstances, goals, presentation and support needs of the person being assessed.  This template is designed to support your documentation process -  not replace your professional judgement.

 

The Supervisionary Partnership resources are developed from real-world occupational therapy and private practice experience.

 

Please note: This resource is intended for professional use and should be reviewed for suitability to your workplace, client and current funding requirements before use.