The Intake Form serves as a crucial first step in establishing a formal relationship between service providers and clients in Belgium. It is designed to collect necessary information while ensuring compliance with Belgian privacy laws, GDPR, and sector-specific regulations. The document must be available in appropriate official languages (Dutch, French, or German) depending on the region of use. This intake form includes mandatory privacy notices, explicit consent mechanisms, and data processing declarations as required by EU and Belgian law. It's particularly important for regulated sectors where detailed client information is necessary for service provision, such as healthcare, legal services, or financial consulting. The form should be structured to collect only essential information relevant to the service being provided, following the data minimization principle of GDPR.
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1. Personal Information: Basic identification details including name, date of birth, national register number (if required), contact information
2. Contact Preferences: Preferred methods of communication and language choice
3. Privacy Notice: GDPR-compliant explanation of how personal data will be processed, stored, and used
4. Consent Declarations: Explicit consent options for data processing, marketing communications, and other specific purposes
5. Service Requirements: Details of the service or assistance being sought
6. Declaration of Truth: Statement confirming that all provided information is accurate and complete
1. Medical Information: For healthcare-related services - includes relevant medical history, conditions, medications
2. Financial Information: For financial services or where payment arrangements are needed
3. Emergency Contacts: When ongoing service relationship requires emergency contact information
4. Professional Qualifications: For professional services or employment-related intake
5. Special Assistance Requirements: For accessibility or special needs accommodations
6. Insurance Information: When service involves insurance coverage or claims
7. Previous Service History: For returning clients or where service history is relevant
1. Privacy Policy: Detailed privacy policy document as required by GDPR
2. Terms and Conditions: General terms and conditions of service provision
3. Service Price List: If applicable, current pricing for services
4. Required Documents Checklist: List of additional documents that need to be provided
5. Consent Forms: Additional specific consent forms that may be required for particular services
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