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TRANSFORMATIVE PSYCHOTHERAPY, L.L.C. Jeannine K. Vegh, M.A., I.M.F.T. Independent Marriage and Family Therapist #F1000006 2572 Oakstone Drive, Suite 4, Columbus, OH 43231 (614) 8137677, transformpsych@outlook.com, http://jkvegh.comINDIVIDUAL INTAKE FORMName: ___Address: ___Phone: (Home) ___ (Work) ___ (Cell) ___Email: ___ (Skype name) ___1. Sex: Male Female 2. Age: ___ Date of Birth: ___3. Marital/Relationship Status: (underline) Single (never married), Significant Other,
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01
Gather all necessary personal information, including your name, contact details, and any relevant medical history.
02
Visit the official website or contact the office of Jeannine Vegh for specific forms required for her psychoformrapy services.
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Fill out the intake form with accurate information about your psychological needs and concerns.
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Mention any previous therapies or treatments you have undergone related to your mental health.
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Indicate your goals for the psychoformrapy sessions and any specific issues you want to address.
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Review your information for accuracy before submitting it.
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Submit the form either online or in person as directed by the office.

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Jeannine Vegh Psychoform Therapy services provide psychological support and therapeutic interventions aimed at helping individuals process emotions, improve mental health, and facilitate personal growth.
Individuals seeking psychoform therapy services, mental health professionals, and institutions providing such services may be required to file relevant information pertaining to the therapy.
To fill out information regarding Jeannine Vegh Psychoform Therapy services, one needs to provide personal details, assessment of mental health needs, and consent for treatment and data recording as required by the service provider.
The purpose of Jeannine Vegh Psychoform Therapy services is to assist individuals in overcoming psychological challenges, improving mental well-being, and achieving personal goals through tailored therapeutic methods.
Information that must be reported includes patient demographics, treatment objectives, progress notes, consent forms, and any relevant assessments conducted during therapy sessions.
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