Follow the steps to effectively complete the Child/Adolescent Intake form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by filling out the 'Patient / Family Information' section. Enter the child/adolescent's name, address, date of birth, school, and grade. Provide the name of the pediatrician and how they were referred.
3. Next, complete the 'Parent/Guardian's Name' section for each guardian. Include their relationship to the child, occupations, home addresses (if different), and phone numbers for home, work, and cell.
4. Indicate the marital status of the parent and provide custody details. If applicable, note the date of divorce and attach custody documents as mentioned.
5. List any other relatives or adults who are important caretakers for your child. Include their names, relationships, and contact numbers.
6. Under 'Developmental and Social History', record details about the pregnancy and delivery, including any problems. Then, outline significant milestones in the child’s development.
7. In the 'Medical History' section, report any illnesses outside of normal childhood diseases, along with any medications the child is currently taking.
8. Proceed to the 'Habits' section, marking any issues observed in the child’s behavior and providing brief descriptions.
9. Fill out the 'School History' section, assessing the child’s experiences at various educational levels and rating each experience.
10. Complete the 'Childcare' section and provide details about where the child is cared for when parents are not present.
11. Address family dynamics by noting relationships and any significant separations or losses affecting the child.
12. In the 'Friends' section, answer questions regarding your child's social interactions and friendships.
13. Detail your child’s interests, strengths, and any significant accomplishments.
14. Identify major areas of concern or problems your child faces and previous attempts at resolution.
15. Use the additional remarks section for any further comments regarding the child’s difficulties. Review the form for completeness.
16. Once all sections are thoroughly filled, save changes, download, print, or share the completed form as needed.

Start completing the Alvord Baker & Associates Child/Adolescent Intake form online today!