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- Fill in the Date of Birth (D.O.B.) and Address fields. This helps establish a clear profile for the client.
- Provide contact details, including Telephone Number and Cell Number. Indicate whether it's okay to leave messages or send texts by checking the appropriate boxes.
- Complete the Email Address section and specify if email communication is acceptable.
- If applicable, fill out Primary and Secondary Insurance Information, ensuring all relevant details like Insurance Carrier, ID#, and Policy Holder are included.
- In the Background Information section, describe any presenting concerns and indicate if involved in legal matters by selecting Yes or No.
- Finally, review all entries for accuracy before submitting your form to ensure a smooth process.
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