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Erica Roll, LPC 1 Client Information Confidential Client Intake Please Print Clients Last Name: First Name: M.I. DOB: Sex: How were you referred? Address: City: State: Zip: Phone: May we leave a voice
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How to fill out erica kroll lpc client
How to fill out erica kroll lpc client
01
Gather all the necessary information about the client, including their personal details, contact information, and any relevant medical or counseling history.
02
Begin by filling out the basic client information, such as their name, address, phone number, and email.
03
Proceed to fill out the client's demographic information, such as their age, gender, marital status, and occupation.
04
Include any emergency contact details in case of urgent situations during the therapy process.
05
Document the reason for seeking counseling or therapy services, including any specific issues or concerns the client wants to address.
06
Record any relevant medical or mental health history, including current medications, previous diagnoses, and past treatments.
07
Use the provided sections to gather information about the client's family history, educational background, and social support network.
08
Ensure to obtain the client's consent for treatment and their agreement to the terms and conditions of therapy.
09
Review the completed form with the client to ensure accuracy and make any necessary corrections or additions.
10
Safely store the filled-out client form in accordance with privacy and confidentiality regulations.
Who needs erica kroll lpc client?
01
Erica Kroll LPC client is primarily designed for individuals seeking counseling or therapy services from Erica Kroll, who is a licensed professional counselor (LPC).
02
Anyone who requires assistance dealing with emotional, mental, or behavioral issues can benefit from Erica Kroll's counseling services.
03
Clients who are dealing with anxiety, depression, stress, grief, relationship problems, or any other psychological challenges can seek help through Erica Kroll LPC client. It is suitable for individuals of all ages and backgrounds.
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