PWP Client Intake

Instructions for Managing PWP Consent to Treat Forms and Demographics Tracking

Before the First Session:

1. Send Consent Packet:
   • When an appointment is scheduled, send the client a consent packet. This packet includes:
     • Consent to Treat Form
     • Demographics Tracking Card
     • Program Evaluation Form

During the First Session:

1. Collect Signed Forms:
   • Ask the client to fill out and sign the following documents:
     • Consent to Treat Form
     • Demographics Tracking Card

1. • Explain that the Program Evaluation Form should be completed after they have finished their services or used up their benefit year sessions.
   • Store the completed forms in the client’s file for billing and demographic tracking purposes.

Ongoing Sessions:

1. Demographics Tracking Card for Sessions 2-4:

1. • At the second, third, and fourth sessions, ask the client to complete the Demographics Tracking Card.
   • Ensure the information is filled out for each session.
   • Print or save the completed form and keep it in the client’s file to aid with billing and demographic tracking.

Annual Update:

1. Renewed Benefit Period:
   • At the beginning of each new 12-month benefit period, during the first billing appointment, have the client fill out a new Consent to Treat Form and Demographics Tracking Card.

Upon Completion of Services:

1. Program Evaluation Form:
   • Provide the client with the Program Evaluation Form at the first session.
   • Ask them to complete it once they have finished their services or exhausted their benefit year sessions.
   • Keep the completed evaluation in the client’s file.

Summary

• First Session: Collect Consent to Treat and Demographics Card.
• Sessions 2-4: Fill out Demographics Tracking Card.
• Each Year: Update forms at the start of a new benefit period.
• Completion of Services: Collect Program Evaluation Form.