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Client Intake Form
I need a Client Intake Form for my London-based physiotherapy practice that includes medical history sections and emergency contact details, compliant with UK healthcare regulations and GDPR requirements.
1. Personal Information: Basic contact details, name, address, contact numbers, email
2. Service Requirements: Nature of services needed, specific requirements or preferences
3. Communication Preferences: Preferred methods of contact and communication
4. Data Protection Notice: Information about how personal data will be used and stored
5. Declaration: Client confirmation of accuracy and consent
1. Financial Information: Payment details and preferences, when financial services are involved
2. Medical Information: Health-related information for healthcare services
3. Emergency Contacts: Alternative contact details for urgent situations
4. Professional References: When required for specific services or industries
1. Privacy Policy: Detailed information about data handling practices
2. Terms of Service: Standard terms and conditions for service provision
3. Service Schedule: Detailed breakdown of services offered and selected
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