Get Family Background Form

Filling out the Family Background Form online is an essential step for individuals seeking counseling services. This guide provides clear instructions on each section of the form to ensure a smooth and efficient process.

Follow the steps to successfully complete the form.

1. Click 'Get Form' button to access the Family Background Form and open it in your online editor.
2. Begin with the personal information section. Enter the client’s name, date, gender, date of birth, and age. Be sure to double-check your entries for accuracy.
3. Provide your address, including the city, state abbreviation, zip code, and any phone numbers where you can be reached. Specify if Wellness Counseling Associates may identify themselves when calling you back.
4. Complete the race/culture, tribe, religion, highest level of education, current employer, and current position fields. This information helps the counseling team understand your background.
5. Indicate your marital status, marking all applicable options. If relevant, fill out your spouse’s or partner’s information with the same details as required for your personal data.
6. List everyone residing in your home, including their names, ages, and relationship to you. This provides context for your living situation.
7. Detail any children not living in your home, specifying their names, ages, and where they reside. This creates a complete family picture.
8. In the Medical Health History section, provide information about your family practitioner and a brief medical history, including any significant health issues affecting you or your family members.
9. For Mental Health History, indicate any previous experiences of you or your family members with mental health issues. Be as specific as you feel comfortable.
10. Complete the substance use history by indicating any substances used, frequency, and any past issues related to substance use. This is crucial for assessing overall well-being.
11. Answer sections related to military service, legal history, and interpersonal & social information. These details contribute to a holistic understanding of your context.
12. Conclude with additional information. Describe any significant life changes, stressors, or reasons for seeking counseling, and state what you hope to achieve through your sessions.
13. Once all sections are completed, review the entire form for completeness and accuracy. You may then save the changes, download, print, or share the form as required.

Take the next step in your wellness journey by completing your Family Background Form online.