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Name: ___ Date: ___ CBT for Insomnia (CBT1) Intake Form PRESENTING PROBLEM & HISTORY 1. On average, how many total hours of sleep do you get per night? ___ (hours per night) 2. What is most upsetting

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How to fill out cbt-i va intake form

01

Make sure to have all necessary information and documents handy before starting the form.

02

Start by filling out your personal information such as name, address, contact details, etc.

03

Fill out the sections related to your medical history, sleep patterns, and any previous treatments for insomnia.

04

Answer all questions honestly and to the best of your knowledge.

05

Make sure to review the form for any errors before submitting it.

Who needs cbt-i va intake form?

01

Individuals who are seeking Cognitive Behavioral Therapy for Insomnia (CBT-I) treatment through the Veterans Affairs (VA) program.

02

Patients with chronic insomnia or sleep disorders who are referred to CBT-I by a healthcare provider.

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What is cbt-i va intake form?

The CBT-I VA Intake Form is a document used to collect essential information from veterans seeking Cognitive Behavioral Therapy for Insomnia (CBT-I) through the Department of Veterans Affairs.

Who is required to file cbt-i va intake form?

Veterans who wish to receive CBT-I services and support from the VA are required to file the CBT-I VA Intake Form.

How to fill out cbt-i va intake form?

The CBT-I VA Intake Form should be completed by providing personal information, medical history, and details regarding sleep patterns and issues as prompted in the form.

What is the purpose of cbt-i va intake form?

The purpose of the CBT-I VA Intake Form is to gather relevant information to assess the veteran's needs for sleep intervention and to create a tailored treatment plan.

What information must be reported on cbt-i va intake form?

Information required on the CBT-I VA Intake Form includes personal identification, contact details, medical history, current medications, and specific sleep-related issues.

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