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Intake Form I. Personal Informational: Are you a former CPT patient or a friend/family member of a former patient? Yes Nonage: Address: Home Phone: () DOB: / / Cell Phone: () Age: Work Phone: () May
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How to fill out tobacco use yes no
How to fill out tobacco use yes no
01
To fill out the tobacco use yes no section, follow these steps:
02
Start by reading the question carefully.
03
If you use tobacco products, select 'Yes'. If you don't use tobacco products, select 'No'.
04
Double-check your answer before submitting the form.
Who needs tobacco use yes no?
01
Anyone who is required to provide information about their tobacco use status needs to fill out the tobacco use yes no section.
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This section is typically included in health-related forms or surveys to gather data on tobacco use for statistical purposes or to determine eligibility for certain programs or benefits.
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