{"id":655,"date":"2023-11-27T11:18:36","date_gmt":"2023-11-27T00:18:36","guid":{"rendered":"https:\/\/eastcoastcareconnect.com.au\/?page_id=655"},"modified":"2023-11-27T11:27:00","modified_gmt":"2023-11-27T00:27:00","slug":"patient-intake-form","status":"publish","type":"page","link":"https:\/\/eastcoastcareconnect.com.au\/patient-intake-form\/","title":{"rendered":"Patient Intake Form"},"content":{"rendered":"

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Client Details<\/h3>\n

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Client Health Information<\/h3>\n

” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Primary_Diagnosis” field_title=”Primary Diagnosis” fullwidth_field=”on” _builder_version=”4.23″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Additional_Relevant_Diagnosis” field_title=”Additional Relevant Diagnosis” fullwidth_field=”on” _builder_version=”4.23″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Services_Required” field_title=” Services Required from ECCC” fullwidth_field=”on” _builder_version=”4.23″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Heading_3″ fullwidth_field=”on” _builder_version=”4.23″ _module_preset=”default” use_field_html=”on” field_htmlcontent=”<\/p>\n

Additional Information<\/h3>\n

” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Heading_4″ fullwidth_field=”on” _builder_version=”4.23″ _module_preset=”default” use_field_html=”on” field_htmlcontent=”<\/p>\n

Plan Manager<\/h4>\n

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Support Co-ordinator<\/h4>\n

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Please also send to ECCC relevant information and documents such as allied health reports, discharge summaries, and care plans prior to service.<\/p>\n

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Note: All information is recorded confidentially on the client\u2019s file.<\/strong><\/p>\n

<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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