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Paul Lee, LCSW INTAKE FORM Name Birth date / / Today's date / / Address Home phone City/State/Zip Work phone Email Cell phone Which number can we leave a message on? Gender Marital status Household:
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What is intake form - portland?
The intake form - Portland is a document used to gather information about individuals seeking services or assistance from the city of Portland.
Who is required to file intake form - portland?
Anyone seeking services or assistance from the city of Portland may be required to file an intake form.
How to fill out intake form - portland?
The intake form can typically be filled out online, in person, or by mail. Specific instructions for filling out the form will be provided by the city of Portland.
What is the purpose of intake form - portland?
The purpose of the intake form is to collect necessary information about individuals in order to determine eligibility for services or assistance.
What information must be reported on intake form - portland?
The intake form may require information such as contact details, income level, household size, and any specific needs or requests for services.
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