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Get Nancy Binford Adolescent Intake Form (Ages 13-19) 2018-2024

Ll that apply to your adolescent. RELATIONSHIPS: o Problems getting along with family o Problems getting along with peers o Difficulty engaging in conversations with peers and/or adults o Difficulty understanding jokes o Poor eye contact o Self-conscious, fear of embarrassment, shy o Uncomfortable socially EXTERNALIZING/DISRUPTIVE: o Acting violently/Losing Temper o Fire Setting o Rule breaking o Property Destruction o Stealing o Cruelty to animals o Running away o Risk taking behavior o Alc.

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