- Name and age of identified client
- Current symptoms or behaviors which interfere with social functioning.
- Recent events or circumstances which may have led you to contact us at this time.
- Identified client’s current location
- Most recent psychiatric hospitalizations or treatment
- Current medications
- Any concerns for the client’s immediate safety?
- Did a treatment professional or agency suggest you contact Pasadena Villa?
- Whether the client, or guarantor wishes to utililze insurance to offset costs of treatment