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Neuropsychology Service, P.A. 277 State Street Suite 2A, Bangor, ME 04401 Phone: 2079902580 Fax: 2079901930 INTAKE INFORMATION ADULT Date of intake Taken by Provider: MM EGG LB Full Half Apt. Date
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Start by gathering all relevant personal information, such as name, age, contact details, and any previous diagnoses or medical history that may be relevant to the evaluation.
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Answer all the questions on the form accurately and as comprehensively as possible, providing detailed information about any symptoms or concerns that you or someone you are filling out the form for may be experiencing.
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Take your time when filling out the form to ensure accuracy and completeness. Double-check all the information before submitting it.
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If you have any questions or need clarification on specific sections of the form, don't hesitate to reach out to the neuropsychology service for assistance. They will be able to guide you through the process and provide any necessary explanations.

Who needs neuropsychology service p:

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Individuals who have experienced a traumatic brain injury or head trauma and are seeking a comprehensive evaluation of their cognitive and psychological functioning.
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Those who are showing signs of cognitive decline or memory impairment and require a thorough assessment to identify potential underlying causes.
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People exhibiting unusual behaviors, mood changes, or difficulty with attention and concentration, and are in need of an evaluation to determine if there are any neurological or psychological factors influencing their symptoms.
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Individuals with neurological or medical conditions that may be affecting their cognitive abilities, such as multiple sclerosis, epilepsy, or Parkinson's disease.
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Anyone who is experiencing difficulties in academic or occupational settings and suspects that it may be due to underlying cognitive or psychological factors.
By following the above steps and considering the target audience for neuropsychology service p, both individuals seeking an evaluation and healthcare professionals referring patients can efficiently complete the necessary paperwork and understand who can benefit from this service.
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Neuropsychology services involve the assessment and treatment of cognitive, emotional, and behavioral issues related to brain functioning.
Neuropsychologists or healthcare professionals specializing in neuropsychology are required to file neuropsychology service p.
Neuropsychology service p can be filled out by providing detailed information about the patient's cognitive abilities, emotional status, and behavioral patterns.
The purpose of neuropsychology service p is to assess, diagnose, and treat individuals with brain-related disorders or injuries.
Information such as the patient's medical history, results of cognitive tests, and treatment recommendations must be reported on neuropsychology service p.
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