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Aimee E. Short, M. Ed. 6451 E Shea Blvd. Scottsdale, AZ 85254Licensed Professional Counselor(480) 3295636 aimee@chaparral.orgIntake Information for Minors Child Patient Informational ___ Age ___ DOB
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01
Open the child intake form in rtf format on a computer or compatible software.
02
Fill out personal information of the child including name, date of birth, address, and contact information.
03
Provide information about parents or guardians such as name, relationship to child, and contact details.
04
Answer questions about child's medical history, allergies, and current health condition.
05
Include any additional information requested on the form such as special needs or preferences.
06
Review the completed form for accuracy and completeness before saving or printing.

Who needs child intake formrtf?

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Any organization or individual responsible for the care of children
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The child intake formrtf is a document used to gather essential information about a child, typically for legal, educational, or healthcare purposes.
Parents, guardians, or custodians of the child are generally required to file the child intake formrtf.
To fill out the child intake formrtf, individuals should complete all required fields accurately, providing details such as the child's name, date of birth, address, and any relevant medical or educational history.
The purpose of the child intake formrtf is to collect necessary information to ensure that the child receives appropriate support and services.
The child intake formrtf typically requires reporting the child's personal information, medical history, guardianship details, and any specific needs or concerns.
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