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Intake Form Lianne Orbit, MA, LPC, NCC Licensed Professional Counselor Date: Referred by: Name: Phone (h): (o): (m): Address: Email: Date of Birth: Brief description of current problem or reason for
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How to Fill Out Intake Form: "20120416 Lizanne Corbit Counseling"
01
Start by carefully reading through each section of the intake form. Familiarize yourself with the information that is being requested.
02
Begin with the personal information section. Fill in your full name, date of birth, address, phone number, and email address. Make sure to double-check the accuracy of the information provided.
03
Move on to the medical history section. Answer the questions regarding any existing medical conditions, allergies, or medications you are currently taking. Be honest and provide as much detail as possible to ensure accurate assessment.
04
Next, complete the mental health history portion. Provide information about any previous counseling or therapy experiences, mental health diagnoses you may have received, or any specific concerns you want to address during the counseling sessions.
05
Proceed to the lifestyle and social history section. Answer the questions related to your occupation, education, relationships, and social support system. This information will assist the counselor in understanding your current circumstances and how they may be contributing to your mental health.
06
Respond to the questions regarding your goals and expectations for counseling. Be clear and specific about what you hope to achieve through the counseling process. This will help the counselor tailor the treatment plan to meet your needs.
07
Finally, review the completed intake form to ensure all the requested information is provided accurately. If any sections are unclear or if you need further guidance, don't hesitate to ask for assistance from the counseling staff.
Who Needs Intake Form: "20120416 Lizanne Corbit Counseling"
The intake form "20120416 Lizanne Corbit Counseling" is specifically designed for individuals seeking counseling services from Lizanne Corbit. This form is necessary for both new clients who are beginning counseling for the first time and existing clients who may need to update their information.
Anyone who wishes to engage in counseling sessions with Lizanne Corbit, regardless of age or gender, will be required to complete this intake form. It is an essential step in the counseling process as it provides vital information about the client's medical history, mental health background, and personal circumstances.
It is important to keep in mind that this intake form is tailored specifically for Lizanne Corbit's counseling practice. Other therapists or counseling centers may have different intake forms with similar purposes. Therefore, individuals seeking counseling services are advised to fill out the intake form that corresponds to their specific therapist or counseling center.
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Intake-form-20120416-lizanne-corbit-counseling is a standardized form used for counseling sessions with Lizanne Corbit.
Clients seeking counseling sessions with Lizanne Corbit are required to file the intake form.
The intake form can be filled out by providing accurate and detailed information about the client's personal and medical history.
The purpose of intake-form-20120416-lizanne-corbit-counseling is to gather necessary information to ensure effective counseling sessions with Lizanne Corbit.
The intake form must include details about the client's personal information, medical history, reason for seeking counseling, and any relevant background information.
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