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THE JOY COUNSELING CENTER CONFIDENTIAL CLIENT INTAKE FORM GENERAL INFORMATION Date: Referred by: Full Name: Mr. Mrs. Ms. Miss Dr. Rev. Nickname: Name You Prefer: Social Security: Age: Date of Birth:
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Northland Counseling Center is a mental health service provider that offers counseling, therapy, and support services to individuals and families in need.
Individuals and providers who are seeking mental health services or funding for services through Northland Counseling Center may be required to file certain documentation.
To fill out documentation for Northland Counseling Center, individuals should complete the necessary forms provided by the center, ensuring all required information is accurately filled in.
The purpose of Northland Counseling Center is to provide mental health services, promote well-being, and support individuals in navigating their mental health challenges.
Required information may include personal identification details, mental health history, current issues, and any services being sought.
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