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Glenise Parrott, LCSW 1122 Sam Newell Rd Suite 106 Matthews NC 28105Phone: (704) 2438776 Email: gparrott@charlottetherapist.comCLIENT INTAKE FORM (Please Print) Todays Date ___/___/___CLIENT INFORMATION
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How to fill out client intake form

01
Start by gathering the necessary information about the client, such as their name, contact details, and any relevant identification numbers.
02
Include a section to gather information about the client's background, such as their personal and employment history.
03
Have a section dedicated to collecting information about the client's current needs or reasons for seeking your services.
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Include a section for the client to provide any relevant medical or health information.
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Add a section to gather information about the client's financial situation, including income, expenses, and assets.
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Include any additional sections that are specific to your industry or the services you provide.
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Use clear and concise language throughout the form, and make sure it is easy to understand and fill out.
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Provide clear instructions on how to submit the completed form, whether it is through email, in person, or by mail.

Who needs client intake form?

01
Client intake forms are typically needed by professionals or organizations that provide services to clients. This can include lawyers, therapists, healthcare providers, consultants, and many others. The form helps gather important information about the client, which can be useful for assessing their needs and providing appropriate services.

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A client intake form is a document used to collect essential information from clients before starting a service or a consultation. It typically includes personal details, service needs, and consent for information sharing.
Generally, clients seeking services from professionals such as lawyers, therapists, or medical providers are required to fill out a client intake form.
To fill out a client intake form, clients should carefully read each section, provide accurate personal and contact information, answer questions regarding their needs or concerns, and sign any required consent agreements.
The purpose of a client intake form is to gather relevant information that helps professionals understand the client's needs, assess risks, and provide tailored services effectively.
Typically, client intake forms require reporting personal information such as name, address, contact details, service requirements, medical history (if applicable), and consent to treatment or services.
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