Get Dbt Eastside

Filling out the Dbt Eastside Client Intake Form is an essential step in accessing support services. This guide will take you through the process of completing the form online, ensuring you understand each section and its importance.

Follow the steps to complete the Dbt Eastside Client Intake Form.

1. Press the ‘Get Form’ button to acquire the form and open it in the editing interface.
2. Begin by entering your full name in the designated field, followed by your age and date of birth. This information is crucial for the service provider to understand your background.
3. Provide your current address and city of residence. Complete the cell phone section and indicate if it is permissible to leave a message by selecting 'Y' for Yes or 'N' for No.
4. In the preferred way to contact you field, specify how you would like to be reached, such as via phone or email.
5. Indicate how you found out about Dbt Eastside by filling in the corresponding field.
6. Input your physician's name if applicable, along with the name of your employer or school and your grade level.
7. Fill in the gender identification and sexual orientation fields. Select whether you are sexually active by marking 'Y' for Yes or 'N' for No.
8. Complete the race or ethnicity section with your relevant information.
9. Choose your relationship status from the provided options, such as Single, Married, Partnered, or others listed.
10. For users under 21, specify your relationship with your parents along with your parents' relationship status.
11. List the people you live with, including their names, ages, and your relationship to them.
12. Answer the mental health information questions regarding previous counseling experiences and the reasons for seeking help.
13. Detail your medication information, including the name of the medication, dosage, the start date, and the prescribing physician's name.
14. Check any issues that concern you from the listed options to help the therapist understand your current challenges.
15. If applicable, provide information regarding trauma or losses experienced in your life, and identify your support system.
16. Complete the emergency contact portion with two names, their relationship to you, and their phone numbers.
17. After finishing the form, ensure all sections are complete before saving changes, and select your option to download, print, or share the form as necessary.

Start filling out the Dbt Eastside Client Intake Form online today to access the support you need.