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2927 SE 71st Avenue Portland, OR 97206 503.233.2236 Phone 503.233.3918 FAX shiatsu theshiatsucenter.com Email www.theshiatsucenter.com Web CONFIDENTIAL INTAKE FORM PART 1 PATIENT INFORMATION Date
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What is confidential intake form?
The confidential intake form is a document used to gather sensitive information from individuals in a private and secure manner.
Who is required to file confidential intake form?
Individuals or entities who are mandated by law or policy to submit the confidential intake form must do so.
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The confidential intake form can be filled out by providing accurate and detailed information in the designated fields on the document.
What is the purpose of confidential intake form?
The purpose of the confidential intake form is to collect important data for analysis, assessment, and decision-making in a confidential manner.
What information must be reported on confidential intake form?
The confidential intake form typically requires personal information, contact details, demographic data, and specific details related to the purpose of the document.
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