Get Premarital Counseling Intake Form

Completing the Premarital Counseling Intake Form online is a straightforward process designed to gather essential information that will aid in your counseling journey. This guide provides step-by-step instructions to assist you in filling out the form accurately and efficiently.

Follow the steps to complete the form smoothly.

1. Click ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering the personal information for Partner 1. This includes their first name, last name, middle initial, street address, city/state, date of birth, zip code, social security number, gender, highest level of education completed, and religious affiliation if applicable. Check the boxes for permissions regarding messages on home, work, and cell phones, and provide an email address along with the preferred method of contact.
3. Provide details about the employer and length of employment for Partner 1. Indicate the occupation and the name of the person responsible for payment. Include how you learned about the counseling office and details for an emergency contact.
4. Fill out the medical and mental health history information, stating if Partner 1 is currently being treated by a physician or taking medication. Indicate if they have previously seen a psychiatrist or another mental health provider, including the focus of treatment.
5. Complete the alcohol and substance use survey for Partner 1. Choose the frequency of alcohol consumption, the number of drinks on consumption days, and provide information on any other substances used, with the option to discuss privately with the therapist.
6. Address the risk assessment section for Partner 1, detailing any family history of mental illness or substance abuse and listing supportive individuals or groups. Respond to questions about any personal history of abuse and thoughts of self-harm.
7. Now, repeat the filling process for Partner 2, following the same steps for personal information, medical history, alcohol and substance use, and risk assessment.
8. Answer questions regarding the couple's relationship and family information: duration of the relationship, engagement length, wedding date, previous marriages, children, and pets.
9. Define premarital goals by agreeing on specific goals to address in counseling and ranking areas where assistance is needed.
10. Each partner must read and sign the confirmation of the truthfulness of the provided information, commitment to therapy, and understanding of cancellation policies. Include printed names, signatures, and dates.
11. Finally, review the completed form for any missing information. Once satisfied, you can save changes, download, print, or share the form as needed.

Get started by filling out your premarital counseling intake form online today.