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Client Intake Form

Before we begin working together, this form helps us understand your current circumstances, well-being, and what support is most appropriate for you.

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Everything you share is used to ensure your experience is safe, ethical, and tailored to your needs, in line with professional safeguarding responsibilities.

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Each section has a purpose, explained briefly, so you know how your information is used.

Eligibility & Contact Details

To confirm eligibility, maintain accurate records, and manage communication about your sessions.

Date of Birth
Day
Month
Year
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