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How to use or fill out the Intimate Partner Violence: Encouraging Disclosure and Referral in the Primary Care Setting form online
This guide provides clear and supportive instructions for filling out the Intimate Partner Violence form, focusing on encouraging disclosure and referral. The form is essential for healthcare providers to assess and address intimate partner violence effectively.
Follow the steps to complete the form online
- Press the ‘Get Form’ button to access the form and open it in your preferred document editor. This will allow you to view and edit the form as needed.
- Begin by filling in your contact information in the designated fields. This typically includes your name, degree, mailing address, telephone number, and email address.
- Review the instructions carefully and ensure that you understand the purpose of the form. It is designed to assist healthcare providers in screening for intimate partner violence.
- Complete the screening section, utilizing the 4-question Abuse Assessment Screen provided in the form. Ensure each question is answered truthfully based on the patient's disclosures.
- If abuse is disclosed, document the findings thoroughly as outlined in the clinical assessment section of the form. This is crucial for referral and support.
- Refer the patients who have disclosed intimate partner violence to appropriate social and legal services through the resources mentioned in the form.
- Once all information is filled, review the completed form for accuracy and completeness. Afterwards, you can save changes, download, print, or share the form as necessary.
Complete the necessary documents online to help support those affected by intimate partner violence.
The term cycle of violence refers to repeated and dangerous acts of violence as a cyclical pattern, associated with high emotions and doctrines of retribution or revenge. The pattern, or cycle, repeats and can happen many times during a relationship.
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