Get Client Face Sheet 2011-2025

Filling out the Client Face Sheet online is an essential step for individuals seeking counseling services at Centus. This guide provides clear instructions to assist you in completing each section of the form accurately and effectively.

Follow the steps to successfully complete the Client Face Sheet online.

1. Press the ‘Get Form’ button to obtain the Client Face Sheet and open it in your preferred online form editor.
2. Begin by filling out your name in the designated fields: first, middle, and last names.
3. Enter your complete street address, including the city, county, state, and ZIP code.
4. Provide your phone numbers, including your home and cell numbers, in the corresponding fields.
5. Select your gender by marking the appropriate option: male, female, or transgender.
6. Indicate your race or ethnicity by choosing from the provided options and filling in 'other' if necessary.
7. Input your social security number in the specified format.
8. Fill in your date of birth to confirm your age.
9. Indicate your current marital status by selecting the applicable option.
10. State your gross family income by choosing the appropriate range provided.
11. Describe your spiritual or faith background by noting past and present affiliations, as well as your current place of worship if applicable.
12. Complete the referral data by entering who referred you and your relationship to that person.
13. In case of an emergency, fill out the emergency contact section with the name, relationship, and phone number of your emergency contact.
14. Review all information entered for accuracy before signing the form. Ensure all necessary fields are filled out.
15. After completing and verifying the information, save your changes, download a copy, print the form, or share it as required.

Start filling out your Client Face Sheet online today to ensure a smooth intake process.