Get Confidential Client Intake Form - The Red Tent

Completing the Confidential Client Intake Form is an important step in receiving personalized care. This comprehensive guide will walk you through each section, ensuring that your submission is thorough and accurate.

Follow the steps to effectively complete the form.

1. To begin, click the ‘Get Form’ button to access the intake form and open it in your editor.
2. Fill in your personal information at the top of the form, including your name, date of initial visit, address, phone numbers, email, date of birth, age, occupation, and marital status.
3. Indicate how you were referred to the service and provide information on any previous massage or bodywork experiences.
4. In the 'Reason for Visit' section, share your primary concerns along with any additional issues. Be specific about when you first noticed these concerns and what factors may have contributed to them.
5. Complete the 'Family History' section by providing information about your family members, including significant health issues and any history of abuse or substance issues.
6. Fill out the 'Digestion & Elimination' part, detailing typical meals, dietary habits, and any gastrointestinal symptoms.
7. In the 'Emotional & Spiritual' section, reflect on your self-perception, emotional challenges, and hobbies that bring joy.
8. Address the 'Sexual and Physical Abuse History' section with sensitivity to your experiences. Answer the questions honestly and take your time.
9. Complete the 'Medical History' section by listing current treatments, medications, allergies, and any surgeries or traumas you have experienced.
10. For the 'Female Reproductive Health History' section, provide detailed menstruation history, pregnancies, and any relevant complications.
11. Read through the client confidentiality release form, ensuring you understand your rights, then sign and date it.
12. Finally, review the entire form for accuracy. Once satisfied, save your changes, download a copy for your records, and share it as needed.

Complete your confidential client intake form online today and take the first step towards personalized care!