Get Mi Jason G. Stentoumis Child Intake Assessment Form 2016-2025

The MI Jason G. Stentoumis Child Intake Assessment Form is a crucial document used to gather important information about a child seeking psychological assessment. This guide provides comprehensive, step-by-step instructions to ensure that users can complete the form effectively and accurately in an online format.

Follow the steps to fill out the form seamlessly.

1. Click ‘Get Form’ button to obtain the form and access it in the online editor.
2. Begin filling out the identifying information at the top of the form. Enter the child's name, date of birth, age, grade, race/ethnicity, religious affiliation, and social security number. Also, include the name of the person completing the form and the date.
3. Complete the section for the mother's information. Fill in her name, date of birth, home phone, address, race/ethnicity, religious affiliation, and highest grade completed. Choose her marital/relationship status and employment status from the provided options. Include her current employer details, years on the job, and permission for contact.
4. If applicable, provide the step-parent's information as outlined, ensuring to fill in all required fields such as name, date of birth, and employment details.
5. In the 'Reason for Seeking Treatment' section, provide a detailed description of the child’s problems and the circumstances that led to seeking assistance. Include aspirations for treatment outcomes and other stressors impacting the child.
6. Complete information on the child’s education, development, medical care, interests, and any additional notes deemed important. Ensure every section is filled accurately for a comprehensive profile.
7. Once all sections are complete, users can choose to save changes, download the completed form, print it for physical records, or share it electronically as required.

Take the first step in documenting your child's needs by completing the MI Jason G. Stentoumis Child Intake Assessment Form online today.