Get Addsoicom Form

The Addsoicom Form is a vital document that collects essential information to help plan your care at SOI Counseling. This guide will provide you with step-by-step instructions to successfully complete the form online, ensuring you provide all necessary details accurately.

Follow the steps to complete the Addsoicom Form online.

1. Press the ‘Get Form’ button to download the Addsoicom Form and open it in your editor of choice.
2. Begin by entering your personal information. Fill in your name, today's date, address, birthdate, city, state, zip code, age, and phone numbers for home, work, and cell as required. Indicate if it is acceptable to leave messages on the home and work numbers.
3. Provide your Social Security Number (SSN), occupation, email address, and emergency contact details including their name, relationship, and phone number.
4. Complete the primary insurance section with the insured person's name, authorization number, SSN, copay amount, date of birth, employer, mental health carrier, relationship to insured, member number, and policy/group number.
5. Describe your areas of concern, including reasons for seeking treatment, the onset of these issues, any events that may have influenced them, and your goals for treatment.
6. In the next section, answer questions about any legal involvement, family psychiatric history, medications, and previous hospitalizations.
7. Provide detailed information about your immediate family members, including their names, ages, relationships, and occupations.
8. Fill out the substance use history accurately by indicating any substances used, when you first and last used them, and any related problems.
9. Review the treatment philosophy, confidentiality, financial terms, and emergency procedures included in the document, ensuring you understand each section before proceeding.
10. Sign and date the form in the appropriate sections, authorizing the release of information for your health plan as necessary.
11. Once you have completed all the fields, save your changes. You may then download, print, or share the document as needed for your submissions.

Complete the Addsoicom Form online today to initiate your care process effectively.