Back to Standard Intake Queue
LO
Leilani Ortega
DraftIN-004130 · DOB 1998-01-17
Date Created
2026-09-03
Case Manager
Assessor
Nadia Osei
ProviderOne ID
Not provided
MedicAid Eligibility
Pending
WLP Status
Pending
Service County
King
Service City
Seattle
Authorization, Consent Form, and Pre-Qualify Eligibility Questionnaire must be Client Signed / Uploaded before moving this intake from Draft to New.
Client Information
First Name
Leilani
Last Name
Ortega
Date of Birth
1998-01-17
Phone Number
Center
Washington State
Program
Employment
Staff Assignment
Case Manager
Assessor
Nadia Osei
Date Assigned
2026-09-03
Program Health & Risk Information
Employment
Diagnosis
Not recorded
Health Factors
Not recorded
Risk Factors
Not recorded
Recorded during intake from the client's initial assessment.
Treatment Status
Unknown / Not Reported
Unknown / Not Reported
Defaults to Not Assessed. High or Medium risk clients appear on the Dashboard High & Medium Risk Clients widget.
Current Situation Duration
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Enter the number of days based on the client's current situation.