Get the free Adult Intake Packet - Tulane School of Medicine
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Client Information Sheet Name Home Phone Cell Spouse/Secondary Name Work Cell Mailing Address City State Zip Physical Address City State Zip Email Address (Check all that apply): Military Y / N Policeman
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How to fill out adult intake packet
How to fill out adult intake packet
01
Start by downloading the adult intake packet from the website or request a physical copy from the department.
02
Read through all the instructions and gather any necessary documents or information you may need to complete the packet.
03
Begin by filling out the personal information section, which may include your name, date of birth, address, contact information, and social security number.
04
Proceed to fill out the medical history section, providing details about any existing medical conditions, past surgeries, allergies, and medications you are currently taking.
05
Complete the insurance information section, providing details about your health insurance coverage, including the policy number and contact information of your insurance provider.
06
If applicable, fill out the employment information section, including details about your current or previous employment, income, and employer's contact information.
07
Take your time to accurately answer all the questions and provide any additional information requested in the packet.
08
Once you have completed filling out all the sections, review the packet to ensure all the information is accurate and complete.
09
Sign and date the necessary sections of the packet as required.
10
Make a copy of the completed packet for your records, if desired, and submit the original packet as directed, either by mail or in person.
11
Keep a note of any confirmation numbers or receipts related to the submission of the adult intake packet.
12
Wait for further instructions or communication regarding the processing of your intake packet.
Who needs adult intake packet?
01
The adult intake packet is generally required by individuals who are seeking services or assistance from a specific department or organization that serves adults. This may include individuals seeking medical care, counseling services, social assistance, legal aid, or other types of support services. The specific requirements for who needs to fill out an adult intake packet may vary depending on the organization and the particular services being sought.
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