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FAITH BEHAVIORAL HEALTH Jim Hughes, Therapist 4300 Punjab Way, Unit # 140 Frisco, TX 75034 Tel. (469) 530.2244 Fax. (469) 804.9311 faithbehavioralhealth@proton.mePATIENT INFORMATION First NameMiddle

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How to fill out intake forms jim

01

Start by entering personal information such as name, address, and contact details.

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Provide details about your medical history, allergies, and any current medications you are taking.

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Answer questions about your reason for seeking treatment and any symptoms you are experiencing.

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Sign and date the form to acknowledge that the information provided is accurate.

Who needs intake forms jim?

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Patients seeking medical treatment from a healthcare provider named Jim would need to fill out intake forms.

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