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COUNSELING INTAKE FORM SECTION I: PERSONAL INFORMATION Name: Date of Birth: SSN#: Address: City: State: Zip Code: Home Phone: Work Phone: Email: Gender: M F Emergency Contact: Phone: Relationship:
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The counseling intake form is a document that collects important information about a client's personal background, medical history, and reason for seeking counseling services.
Any individual or client seeking counseling services is required to file a counseling intake form.
To fill out the counseling intake form, the individual or client needs to provide accurate and complete information about their personal background, medical history, and reason for seeking counseling services.
The purpose of the counseling intake form is to gather necessary information about a client's background, which helps counselors assess their needs, provide appropriate treatment, and ensure the safety and well-being of the client.
The counseling intake form typically requires information such as the client's full name, contact details, demographics, medical history, mental health concerns, current medications, and emergency contact information.
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