Get Brian Stemetzki

The Brian Stemetzki intake form is designed to gather essential information to help facilitate productive therapy sessions. This guide will provide clear, step-by-step instructions to complete the form accurately and effectively online.

Follow the steps to fill out the Brian Stemetzki intake form online.

1. Click the ‘Get Form’ button to access and open the form in the online editor.
2. Begin by entering the date of your first appointment, which is typically found at the top of the form.
3. Provide your referral source. Indicate how you learned about the services (e.g., medical provider, insurance provider, friend/family, etc.). Fill in any relevant names or details as required.
4. Choose whether you have previously received mental health services by selecting 'Yes' or 'No.' If yes, check the types of services you have received, such as psychotherapy or medication, and provide further details like the name and location of the provider, treatment dates, and reasons for treatment.
5. Answer the question about what brings you in today. Be specific in describing your current issues and the duration of your problems.
6. Indicate whether you are experiencing overwhelming sadness or anxiety by checking 'Yes' or 'No,' and provide additional information regarding the duration or specifics of these conditions.
7. Fill out the family history section, which includes your birthplace, upbringing, and details about your family members. List your parents and siblings with their ages and locations, and indicate any relevant family history of mental health issues.
8. Complete the marital status field by selecting the appropriate option and answering any follow-up questions regarding relationships and children.
9. In the physical health section, list any medications, herbs, or supplements you are taking along with relevant health details and provider information.
10. Rate your physical health and sleeping habits using the designated scale, and provide any additional information about your current conditions.
11. Finally, answer the questions about your work, interests, strengths, and weaknesses. Review all your answers to ensure accuracy and completeness.
12. Once you have filled out all sections, save your changes, and choose to download, print, or share the form as needed.

Complete your Brian Stemetzki intake form online today for a smoother start to your therapy experience.