Client Intake Consent Form
Please complete this form to collect and use your information for service purposes.
Consent & Agreement
Collection & Use of Information: I consent to collecting and using my information for service-related purposes.
Confidentiality & Privacy: I understand my information will be kept confidential and only used as necessary.
Communication: I agree to be contacted by the company via phone, email, or other preferred methods.
Liability & Responsibility: I acknowledge that I have provided accurate information and understand the risks associated with the services provided.
Terms & Conditions: I have read and agree to the company's policies and procedures.
Name:
Date:
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