Get the free Download Adult Intake bFormb - Durham Natural Health Centre - dnhc

Durham Natural Health Center www.DNHC.ca (905)6192525 Patient Intake Form Please take the time to fill out the following form. The following form is designed to provide insight into your personal

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3. Carefully read through the instructions provided at the beginning of the form to ensure you understand the purpose and requirements of the intake form.
4. Begin filling out the form by entering your personal information, such as your full name, date of birth, address, and contact details.
5. Provide any relevant identification information requested, such as your driver's license number or social security number.
6. If applicable, indicate your marital status and provide the necessary details regarding your spouse or partner.
7. Complete the section that requires you to disclose your medical history and any pre-existing conditions. Be thorough and accurate while filling out this section as it will help determine the appropriate course of action for your intake.
8. Answer any additional questions or sections that are specific to the purpose of the intake form, such as questions related to mental health, substance abuse, or legal matters.
9. Review the filled-out form for any errors or missing information. Ensure that all the required fields have been completed accurately.
10. Once you are satisfied with the information provided, save a copy of the filled-out form on your computer for your records.
11. If instructed to do so, print out the form and sign it where required. Otherwise, submit the completed form as directed by the issuing authority.

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