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Adult Intake Form Basic Information Full Name: Address: City:State:Cell:Zip:Home:Date of Birth:Work: Sex: O Preoccupation:O FemaleMarital Status? O MOWODOSDo you primarily: O Sit O Stand O Perform

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Gather all the necessary information such as full name, date of birth, address, etc.

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Any individual who is required to provide information for official purposes such as government agencies, employers, or educational institutions.

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Fill out form adult is a document that adults must complete to provide specific information.

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