Get Psychiatric Intake Form

Filling out the psychiatric intake form online is a crucial step in ensuring that the assessment process for mental health services is thorough and accurate. This guide will walk you through each section of the form to ensure you provide all necessary information effectively and confidently.

Follow the steps to complete your psychiatric intake form with ease.

1. Use the ‘Get Form’ button to access the psychiatric intake form and open it in your chosen editor.
2. Begin with the patient contact information section. Fill in the patient's name, age, and date of birth as prompted. Include the patient's address, contact number, and email.
3. Provide details about the primary care physician, including their name, phone number, and fax number. Also, fill in the pharmacy information.
4. Next, complete the parent or guardian's information. Include their name and the best contact numbers. Select the appropriate marital status for the parents.
5. If applicable, detail the custody arrangements if the parents are divorced, and provide the other parent's contact information.
6. Outline where the child was born and whether they have moved often during their upbringing, noting the ages and locations of these moves.
7. In the school history section, specify the current grade level, school name, and contact details. Summarize the child's progress throughout their educational journey.
8. List any academic strengths or weaknesses and indicate whether the child has undergone any testing or received special educational supports.
9. In the areas of concern, check all relevant issues affecting the child’s personal, school, and family adjustments.
10. Fill out the abuse history section if applicable, and provide details on any previous involvement with mental health or juvenile services.
11. Complete the teen/young adult section for adolescents, addressing concerns about friendships, substance use, and other important behaviors.
12. If relevant, detail any prior psychiatric treatments, hospitalizations, and current medications, including any side effects noted.
13. Complete the family history section to indicate any mental health issues within the family.
14. Provide any chronic medical conditions, serious injuries, or medical hospitalizations for the child.
15. If applicable, have the adolescent fill out the last section on substance use, detailing usage patterns and any prior substance-related incidents.
16. Finally, review all information entered for accuracy. Once completed, users can save changes, download, print, or share the form as needed.

Complete your psychiatric intake form online to ensure the best possible care for you or your child.