Products tagged with 'client intake form'
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Lawyer Client Intake Questionnaire for Medical Malpractice Claim
This Client Intake Questionnaire allows lawyers to collect the information they need from a client to launch a medical malpractice claim.
- The 15-page form contains numerous sections for information gathering, including:
- personal details about the client, spouse/partner and children,
- employment background,
- the details of the alleged malpractice and the injury resulting from it,
- potential witnesses,
- statements or comments from other medical practitioners,
- medical expenses and other related costs,
- past medical history,
- criminal record,
- client expectations.
- Available in MS Word format and fully editable to fit your exact needs.
$9.99
Confidential Patient Information Sheet for Massage Therapy
Use this downloadable template form to gather confidential information from patients of a massage therapy clinic.
- All new patients should fill out the form before beginning therapy.
- Patients provide medical and contact information, as well as specific details of any existing condition for which the patient is receiving massage treatments.
- The form can be easily customized to include your office and practice information, logo, hours, etc.
- This is a reusable business form. Once you purchase it, you can use it as often as you like.
- This Confidential Patient Information Sheet for Massage Therapy form is downloadable, editable and easy to use.
$2.29
Confidential Patient Health Record for Chiropractic Treatment
Chiropractors, have each new patient fill out this Confidential Health Record and Information Sheet prior to receiving chiropractic treatment.
- The 5-page form includes sections for:
- personal and medical history,
- job-related injuries,
- current health condition, and
- a patient consent form for chiropractic treatment.
- This form is fully editable and reusable. Pay for the form once, and it's yours to use as often as you require.
$7.99
Lawyer Client Intake Questionnaire for Personal Injury Claims
Lawyers can use this Client Intake Questionnaire to collect the information they need from a client to launch a personal injury case.
- The 24-page form contains numerous sections for information gathering, including:
- personal details about the client, spouse/partner and children,
- employment, education, community involvement,
- military service,
- hobbies and activities,
- the accident / incident that resulted in the injury,
- details about the injury, diagnosis, prognosis, treatment and ongoing effects,
- medical expenses, vehicle repair costs, and other related costs,
- insurance details for all vehicles involved,
- medical history,
- driving records,
- criminal history,
- a section for slip and fall injury claims.
- Available in MS Word format and fully editable to fit your exact needs.
$12.99
Referral Acknowledgement and Release
Download this free Referral Acknowledgement and Release form to be signed by a client who has been referred to a lawyer in a specific matter.
- The form releases the referring party with respect to any claims arising from the matter being referred.
- The client acknowledges that they are relying solely on the advice of the lawyer they have been referred to.
- This is a generic form which can be used in many jurisdictions.
- Available in MS Word format.
$0.00
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