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AMERICAN RED CROSS U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES INITIAL INTAKE AND ASSESSMENT TOOL Date/Time: Shelter Name/Location: DO Name/Number: Name of Person: Age: Names/Ages of all family members

How to fill out initial intake and assessment

How to fill out initial intake and assessment:

1. Begin by gathering all necessary forms and documents, such as the client's personal information, medical history, and any relevant consent or release forms.
2. Start with the client's personal information section, including their name, contact information, and any other pertinent details.
3. Move on to the medical history section, where you will ask questions about any pre-existing medical conditions, medications, allergies, or previous surgeries.
4. Consider including a section for the client to provide information about their lifestyle habits, such as exercise routines, dietary preferences, and any substance use.
5. Ask questions regarding the client's mental health, such as any previous diagnoses, current medications, or therapy history.
6. Include a section for the client to share any specific goals or concerns they have in seeking treatment or assistance.
7. Make sure to provide space for the client to express any additional information or comments they deem necessary.
8. Review the completed intake and assessment form with the client to ensure accuracy and ask if there are any missing or unclear details that need clarification.

Who needs initial intake and assessment?

1. Individuals seeking medical or therapeutic treatment: An initial intake and assessment is typically required for individuals who are seeking assistance or treatment in a medical or therapeutic setting. This could include individuals seeking mental health counseling, physical therapy, or medical treatment.
2. New clients or patients: When a person is new to a particular healthcare provider or service, an initial intake and assessment is necessary to gather crucial information about their health history, current state, and goals.
3. Organizations or institutions providing care: Some organizations or institutions require an initial intake and assessment process to ensure that they have all the necessary information about a client or patient before providing care or treatment. This helps in tailoring the services and support they offer to the individual's specific needs.

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What is initial intake and assessment?

Initial intake and assessment is the process of gathering information about a client's background, needs, and goals in order to determine the appropriate level of service.

Who is required to file initial intake and assessment?

Social workers, case managers, and other professionals working in human services are typically required to file initial intake and assessment.

How to fill out initial intake and assessment?

Initial intake and assessment forms can be filled out by interviewing the client, reviewing documentation, and conducting assessments.

What is the purpose of initial intake and assessment?

The purpose of initial intake and assessment is to gather information to develop a plan of care or service that meets the client's needs.

What information must be reported on initial intake and assessment?

Information such as demographics, medical history, social history, and presenting concerns must be reported on initial intake and assessment forms.