Get Parent Intake Form

Filling out the Parent Intake Form online is an important step in providing essential information for family sessions. This guide will walk you through the process, ensuring you can complete the form accurately and efficiently.

Follow the steps to fill out the form with ease:

1. Press the ‘Get Form’ button to download the Parent Intake Form and open it in your preferred online document editor.
2. Begin by entering today’s date at the top of the form. This helps track when the information was submitted.
3. Fill in your full name, including any relevant licenses or degrees you hold, followed by your birth date and age.
4. Provide your height and weight; this information may be relevant for the sessions ahead.
5. Indicate who referred you to the service, as this can help establish your context and connections.
6. Share your intention for attending family sessions, detailing what you hope to achieve.
7. Answer the question regarding any medical conditions that could restrict participation in activities by checking 'Yes' or 'No.' If applicable, provide an explanation.
8. Identify any specific areas of your body requiring special consideration during sessions.
9. List any medications you are currently taking, specifying the name of each medication and its purpose.
10. Disclose if you are using recreational drugs, alcohol, or nicotine and record the amounts consumed weekly.
11. Outline any psychological or bodywork training you have received.
12. Describe your experiences with psychological or bodywork therapy, including durations.
13. Specify if you are currently in therapy or regular bodywork sessions, providing the name of the practitioner and their qualifications if relevant.
14. List any other healthcare providers you are currently seeing to ensure comprehensive care.
15. Indicate your birth history, checking all that apply from the provided options related to your birth.
16. Provide details regarding your prenatal and birth history based on the checklist provided.
17. Answer questions about your early life experiences, including breastfeeding and parental presence.
18. Reflect on your childhood upbringing and parental relationships, providing as much detail as you feel comfortable sharing.
19. Discuss any experiences with loss or emotional impacts related to your birth and early family history.
20. Conclude by signing and dating the form to validate your information before submission.

Encourage others to complete their Parent Intake Form online now to ensure a smooth intake process.