Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in your editing interface.
2. Begin by filling out the client information section. Enter your full legal name, gender, date of birth, address, age, email, and phone numbers. Ensure all details are accurate and complete.
3. Move to the payment information section. Select whether you will self-pay or use insurance, and provide the necessary insurance details if applicable.
4. Address the presenting issues or problems by detailing the issues you wish to work on, your goals, and the duration for which these concerns have been troubling you.
5. Complete the general symptoms and issues section by indicating the severity of your experiences with various symptoms using the provided scale.
6. Fill out the family history section by noting family composition, significant familial relationships, and any relevant mental health or substance use history.
7. Provide information on your spirituality and marital status in the relevant sections.
8. Indicate any physical or mental health conditions you have, along with any current medications and allergies.
9. In the additional information section, include any further details you feel are pertinent for your counselor to know.
10. Once all sections are filled out, sign and date the form to affirm your consent to the office policies and procedures.
11. After completing the form, ensure to save your changes, then proceed to download, print, or share the form as needed.

Begin your journey towards wellness by completing the Andry, MA, LPC form online today.