Intake Screen Record

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File: EFTA00051963_p718_i0.png dataset_9
Summary:

The image shows a scanned 'Intake Screen Record' form, possibly related to psychology services and meeting PREA criteria. The document has handwritten markings and appears to be stained.

Content Type:
Image
Document Type:
image
Date:
2017-01-13
Model Used:
gemini-2.0-flash-001
Image Classification
Category:
document_scan
Subcategory:
form
Objects Detected (1)
form
A scanned form titled 'Intake Screen Record'. The form is stained and has handwritten markings on it. The form also has the text 'Meets PREA Criteria, referred to Psychology Services' printed on it twice.
Intake Screen Record, Meets PREA Criteria, referred to Psychology Services, CALL RECEIVED, DATE:, 7530-00-222-3525 FEDERAL SUPPLY SERVICE (GPO), 000419, Sensitive But
Scene & Environment

Setting: indoor

Location Type: office

Time: unclear

Atmosphere: official

Background: The background is plain and out of focus.

Document Extraction

Type: form

Date: 2017-01-13

Key Points:

  • Intake Screen Record
  • Meets PREA Criteria
  • Referred to Psychology Services

Full Transcription:

Inlavie
RECORD
(913 2017
Meets PREA Criteria,
referred to Psychology Services
CALL RECEIVED
7530-00-222-3525
FEDERAL SUPPLY SERVICE
(GPO)
DATE:
000419
Sensitive But
Text in Image
Inlavie
RECORD
913 2017
Meets PREA Criteria,
referred to Psychology Services
CALL RECEIVED
7530-00-222-3525
FEDERAL SUPPLY SERVICE
(GPO)
DATE:
000419
Sensitive But

Significance: The text provides the title of the document, date, and information about PREA criteria.

Full Description

The image is a scanned document, specifically a form titled 'Intake Screen Record'. The form appears to be stained and has some handwritten markings on it, including what looks like a star. The text 'Meets PREA Criteria, referred to Psychology Services' is printed on the form twice. Other text includes 'CALL RECEIVED', 'DATE:', and a number '7530-00-222-3525' along with 'FEDERAL SUPPLY SERVICE (GPO)'. The document number '000419' is at the bottom. The phrase 'Sensitive But' is written vertically on the right side. The overall quality of the scan is medium, with some areas appearing slightly blurry. The document is centered in the frame, and the background is plain.

Organizations
Raw Analysis