Follow the steps to fill out the Group Intake Form seamlessly.

1. Press the ‘Get Form’ button to access the Group Intake Form and open it for completion.
2. Fill in the child’s or adolescent’s information. Include the patient’s name, date of birth, sex, and home address. Ensure that you also include their home and cell phone numbers.
3. Provide information about the parents or guardians. Include names, dates of birth, ages, and contact numbers (home and cell).
4. Indicate the referral source by providing the name and contact details of the professional who referred your child to therapy. Answer whether you grant permission to release information to this professional.
5. Compose a brief summary of the main problems that led to seeking evaluation for your child. This section allows you to describe any concerns in detail.
6. Describe how your child reacts to stress and anxiety. Provide insights into their emotional and behavioral responses.
7. Detail how your child displays aggression and reacts to authority figures, providing examples if possible.
8. Outline your goals for therapy regarding your child, adolescent, and/or family. This helps to set a framework for the therapeutic process.
9. Check all that apply regarding current life stresses for your child and briefly describe these stresses.
10. If applicable, answer questions about any prior psychiatric hospitalizations, including details about reasons and outcomes.
11. Complete the history of behavior and discipline section. Indicate any instances of lying, stealing, rule-breaking, or legal problems and describe the circumstances.
12. Report on your child’s sleep behavior, noting any issues such as nightmares, sleepwalking, or sleeping difficulties.
13. Complete the school history section, including current grade, last school attended, and any homework or learning-related issues.
14. Document family history related to mental health and medical problems that may impact therapy outcomes.
15. Sign and date the informed consent portion, confirming your understanding and agreement to the therapy terms outlined in the document.
16. Once complete, you can save changes to the document, download it for your records, print the form if necessary, or share it as required.

Start filling out the Group Intake Form online today to take the first step toward supporting your child's mental health.