Get Tx Nancy Stroud Lcsw Psychotherapist Adolescent Intake Form 2016-2025

Filling out the TX Nancy Stroud LCSW Psychotherapist Adolescent Intake Form online is a vital step in initiating the therapeutic process for adolescents. This form collects essential information about the adolescent, their family, and any presenting concerns to assist the therapist in providing appropriate care.

Follow the steps to successfully complete the online form.

1. Click ‘Get Form’ button to obtain the form and access it for completion.
2. Begin by entering the adolescent's age and full name in the designated fields. This information is critical as it helps the therapist to personalize the care specific to their developmental stage.
3. Provide the date of birth (DOB) for the adolescent and each sibling, if applicable. This helps to ensure accurate age-related assessments.
4. Enter the parental information including the parent's name, DOB, marital status, and contact information. This section assists the therapist in understanding family dynamics.
5. Fill in the emergency contact details, including name and phone number. This is important for safety purposes.
6. Address the history of the problem by describing any concerns about the adolescent. Specify how long these issues have existed and note any significant family stressors.
7. Check the symptoms that the adolescent may currently be experiencing, providing details for each listed symptom regarding severity and duration.
8. Indicate any involvement with external agencies such as child protective services, if applicable, particularly for families facing custody arrangements.
9. For adopted adolescents, indicate whether the child is aware of their adoption status, and provide the relevant details.
10. Complete the parent or guardian signature sections to indicate consent and agreement to the terms outlined within the form.
11. Once all fields are accurately completed, users can save changes, download, print, or share the form as needed.

Complete your adolescent intake form online today to begin the path towards effective therapy.