Follow the steps to complete the form accurately and effectively.

1. Click ‘Get Form’ button to access the MD CCC Group Intake And Screening Form and open it for completion.
2. Begin by entering the date at the top of the form. This helps to keep track of when the information was provided.
3. Provide the child’s date of birth and current school. Completing these fields is essential for understanding the child’s context.
4. Enter the child’s home address and contact number. This information is crucial for any necessary communication.
5. Respond to the question about how you heard about the group. This feedback can be useful for organizational purposes.
6. Answer the queries about any mental health or learning disorder diagnoses. Providing this information helps in assessing the needs of your child.
7. List any outside therapists, psychiatrists, or other providers involved in the child’s care. This context is important for integrated support.
8. Describe the child’s communication abilities as well as any behavioral concerns such as aggression or social engagement difficulties.
9. Detail any experiences of worry or anxiety the child faces, including specific fears or phobias that may impact their participation.
10. Conclude by explaining what you and your child hope to gain from this group experience for goal-oriented support.
11. Finally, do not forget to add the parent’s signature and date to validate the form before submission.

Complete the MD CCC Group Intake And Screening Form online to ensure your child receives the support they need.