Get Pa Jodi Bremer-landau Welcome To My Practice Intake Packet 2016-2025

Completing the PA Jodi Bremer-Landau Welcome To My Practice Intake Packet is an important step in your journey towards improved mental health. This guide will provide you with a clear and supportive outline for filling out the form online, ensuring that you understand each component and its purpose.

Follow the steps to fill out your intake packet efficiently.

1. Press the ‘Get Form’ button to access the intake packet. This will allow you to download and open the document for editing.
2. Begin by filling out basic information such as your name, preferred nickname, and contact details including your home phone, work phone, and cell phone. Ensure that all information is accurate for effective communication.
3. Enter your email address and birth date. This information is essential for appointment reminders and identification.
4. Select your preferred method for automated appointment reminders: text, phone call, email, or confirm that no confirmations are needed.
5. Indicate the source of your referral and provide details for an emergency contact, including their name, relationship to you, and phone number.
6. Complete the section regarding financial responsibility by identifying the person responsible for the account and their relationship to you. Fill in your marital status and the number of previous marriages.
7. List your current spouse or partner's name alongside their phone number(s). Proceed to provide information related to race/ethnicity and sexual orientation.
8. Indicate if you are a veteran and provide details about your employment or educational status, including your employer or school name.
9. Describe your presenting concerns and any previous treatment you have received for your mental health.
10. Fill out medical and mental health conditions, medications, and the name and contact information of your physician or health care provider.
11. Address any sleep concerns, nutritional status, trauma history, substance abuse history, and legal history.
12. Outline your current family makeup and childhood family background along with your support system, including friends and community organizations.
13. Conclude with a list of your leisure activities and personal strengths.
14. Once all fields are filled, review the information for accuracy. Save your changes, and you may choose to download, print, or share the completed form as needed.

Begin completing your intake packet online today to take the first step towards your mental health journey.