Get Counseling Fillable Intake Form

Completing the Counseling Fillable Intake Form online is an essential step in initiating your counseling journey. This guide will provide you with clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to successfully complete your intake form.

1. Press the ‘Get Form’ button to access the Counseling Fillable Intake Form and open it in your browser or PDF editor.
2. Begin by filling in your personal information, such as your name, today's date, date of birth, relationship status, age, and social security number (SSN). Make sure to complete each field accurately.
3. Provide your contact details, including your home or mobile phone number, work phone number, and email address. Indicate whether it is okay to leave messages at these numbers.
4. Enter your mailing address and fax number if applicable. Include your current employer's details, your position title, and your current occupational status.
5. Describe your physical health, including current medications, any doctor’s care, and any recent hospitalizations or illnesses.
6. Fill out the family data section, providing details about your parents, siblings, marital status, and children. Be prepared to share information about family dynamics and history of any relevant issues.
7. In the legal data part, answer questions related to past incarcerations or legal issues, if applicable.
8. Address your religious preference and provide information about your emotional state, including any previous therapies or counseling you have received.
9. If relevant, indicate any experience with chemical dependency or addiction treatment and describe any supportive recovery programs you are involved in.
10. Review the behavior and feelings sections, checking off any that apply to you, followed by physical symptoms you may experience.
11. List your perceived strengths and weaknesses, as well as any support systems you have and issues you wish to address in counseling.
12. Read the personal agreements section carefully, acknowledging your understanding and agreement before signing and dating the form.
13. Once you have filled out all sections of the form, ensure that all information is correct. After that, you may save changes, download a copy, print the form, or share it with the appropriate party.

Begin filling out your Counseling Fillable Intake Form online today to take the first step towards your counseling experience.