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PATIENT Informational: ___ Referred by: ___Child's Last Name: ___ First Name: ___ Middle: ___ Is there another name the patient prefers to be called? ___ Race/Ethnicity: ___ Date of birth: ___ Age:
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Chapter 12 family violence typically refers to a section in a legal code that addresses issues related to domestic violence within families.
Individuals who have experienced or witnessed family violence may be required to file a report under chapter 12 family violence.
To fill out chapter 12 family violence, one may need to provide details of the incident, names of individuals involved, dates, and any other relevant information as required by the law.
The purpose of chapter 12 family violence is to protect victims of domestic violence, hold perpetrators accountable, and provide necessary interventions and support.
Information that must be reported on chapter 12 family violence may include details of the incident, names of individuals involved, dates, and any other relevant information as required by the law.
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