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The Intake Form serves as a critical first point of contact between service providers and clients in the Netherlands, designed to collect essential information while maintaining compliance with Dutch privacy laws and GDPR/AVG requirements. This document is typically used at the commencement of a service relationship to gather relevant client data, establish service needs, and obtain necessary consents. The Intake Form includes modular sections that can be customized based on industry requirements, whether for healthcare, professional services, or educational purposes. It incorporates explicit privacy notices and consent mechanisms as required by Dutch law, and can be implemented in both digital and physical formats. The document's structure ensures systematic data collection while protecting both the service provider's and client's interests under Dutch jurisdiction.

1. Personal Information: Basic identification details including name, date of birth, contact information, and preferred language

2. Privacy Notice and Consent: GDPR-compliant explanation of data collection purposes and explicit consent request

3. Contact Details: Emergency contacts and preferred method of communication

4. Service Requirements: Specific needs or requirements from the service provider

5. Declaration: Statement confirming accuracy of provided information and understanding of terms