Client Information Tab

CLIENT INFORMATION TAB – Client Profile

Profile Date

• This is the date that the profile was created by the user in CMBHS.
• When creating a Client Profile, this field will display today’s date.
• If today’s date is not the correct date, you may change the date by CLICKING IN the text box and TYPING IN the correct date.
• TYPE IN the 8 numbers that represent the date and CMBHS will format the date with slash marks for you or if you prefer,
• TYPE IN the date in the final format with a forward slash between the month and day and the day and year.
• The date may not be a date in the future but it may be a past date.

 

Client Information

First Name (Required for mental health and substance abuse services).

• Enter the client’s first name.
• Use letters only; no numbers may be entered.

 

Middle Name (Not required by CMBHS for mental health or substance abuse services).

• Enter the client’s middle name, if available.
• Use letters only; no numbers may be entered.

Last Name (Required for mental health and substance abuse services).

• Enter the client’s last name.
• Use letters only; no numbers may be entered.

 

Suffix (Not required by CMBHS for mental health or substance abuse services).

• You may pick one of these answer choices or leave the box blank.

 

Alternate Name and Type (Not required by CMBHS for mental health or substance abuse services).

• If the Client uses an Alternate Name, pick the type of Alternate Name the client uses and then type the name into the text box.
• If an Alternate Name is documented for the client, you can later search CMBHS using the alternate name.
• If the client does not use an Alternate Name, leave blank.

Date of Birth and Age (Required for mental health and substance abuse services).

• If the client gives a Date of Birth, enter it in the Date of Birth box.
• TYPE IN the 8 numbers that represent the date and CMBHS will format the date with slash marks for you or if you prefer,
• TYPE IN the date in the final format with a forward slash between the month and day and the day and year.
• Be sure to include a zero (0) before the days and months that are single digits (1 through 9).
• After a birth date has been entered, the age will be automatically calculated by CMBHS and will display in the Age box below the Date of Birth.
• If the client does not know his/her date of birth, enter the age or approximate age for the client in the Age box.

 

Mother’s Maiden Name (Not required by CMBHS for mental health or substance abuse services).

• This information is used to ensure the correct identification of a client.

 

 

Local Case Number (Not required by CMBHS for mental health or substance abuse services).

• If your organization assigns a unique number to each client, you may enter it here.
• This field accepts letters and numbers.

 

Email Address (Not required by CMBHS for mental health or substance abuse services).

• If your client has an email address, enter it here.
• This field accepts letters, numbers and symbols.

NOTE:

If the client provides an Email Address, ask if anyone besides the client has access to the address

If others also have access to this email address, discuss with the client the consequences of using the address for email related to receiving mental health or substance abuse services.

Be sure the client understands the type of information that is routinely sent by email from your organization.

Demographic Information

Complete all the required data fields and optional fields that are applicable.

 

Gender (Required for mental health and substance abuse services)

• Pick Male or Female

 

Transgender (Not required by CMBHS for mental health or substance abuse services)

• Pick Yes or No or Unknown

CLICK HERE for more information about Transgendered Persons

“Transgender” is an umbrella term used to describe people whose gender identity (sense of themselves as male or female) or gender expression differs from that usually associated with their birth sex. Many transgender people live part-time or full-time as members of the other gender. Broadly speaking, anyone whose identity, appearance, or behavior falls outside of conventional gender norms can be described as transgender. However, not everyone whose appearance or behavior is gender-atypical will identify as a transgender person.

 

Race (Required for mental health and substance abuse services)

• Pick the racial category(ies) that the client uses to identify him or herself.
• You may pick more than one answer.
  • To pick more than one race, hold down the Ctrl key on your keyboard, while you CLICK ON each answer you want to select.
• You may not pick a race (White, American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or other Pacific Islander) and also select Unknown or refused to answer.
• The answer choices are:
  • White
  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or other Pacific Islander
  • Unknown or refused to answer

 

Ethnicity (Required for mental health and substance abuse services)

• You may pick only one answer.
• The answer choices are:
  • Hispanic or Latino
  • Not Hispanic or Latino
  • Unknown or refused to answer.

NOTE:

The answer choices for this data field are determined by the Federal Government, Office of Management and Budget (OMB), per the 2002 US Census definitions.

The OMB requires that these categories be used by DSHS.

Language Preference (Not required by CMBHS for mental health or substance abuse services)

• Indicate the client’s language preference.
• The answer choices are:
  • English
  • Spanish
  • Sign Language
  • Other
    • If you pick Other, you must also document the client’s language preference in the Other Language Preference textbox that displays.
    • CLICK IN the text box and begin TYPING.

 

Marital Status (Required for mental health and substance abuse services)

• This field must reflect the client’s current marital status.
• You may pick only one answer.
• The answer choices are:
  • Currently married
  • Divorced
  • Never Married
  • Widowed
  • Separated

Phone Numbers

The program provides space to document 3 phone number types to be used for the purposes of contacts as authorized by the client, as required by law, as needed in emergency situations and/or for follow-up contact.

NOTE:

Although the following phone numbers are not required by CMBHS, document any phone numbers you are able to obtain from the client.

Home Phone (Not required by CMBHS for mental health or substance abuse services)

• Enter the client’s home number (landline) if they have one.
• Enter 10 numbers and CMBHS will format the numbers into the correct format for you.

 

Work Phone and Extension (Not required by CMBHS for mental health or substance abuse services)

• Enter the client’s work number if they have one. Include the extension if needed.
• Enter 10 numbers and CMBHS will format the numbers into the correct format for you.

 

Cell Phone (Not required by CMBHS for mental health or substance abuse services)

• Enter the client’s cell phone (mobile) number if they have one.
• Enter 10 numbers and CMBHS will format the numbers into the correct format for you.

NOTE:

Along with the User’s location type, the age and gender of the client determine the questions that are displayed in the Assessment.

What’s Next?

• After you have filled in all the required information under the Client Information tab,
  • move your pointer over the Address tab and CLICK. The Address tab of the Client Profile will open OR
• You may Save the incomplete Client Profile in Draft Status and complete it some other time.
• If you choose to continue, complete the Address fields.

CLICK HERE to go back to 'CLIENT PROFILE'.

NEXT,

CLICK HERE to go to the 'ADDRESS TAB'