Get Tx Nancy Stroud Lcsw Psychotherapist Adolescent Intake Form 2017-2025

Filling out the TX Nancy Stroud LCSW Psychotherapist Adolescent Intake Form online is an important first step in your child’s therapeutic journey. This guide will provide you with clear, step-by-step instructions to ensure that you complete the form accurately and thoroughly.

Follow the steps to successfully complete the intake form.

1. Click ‘Get Form’ button to access the intake form and open it in your chosen document editor.
2. Begin by entering your child's personal information. Include details such as their name, date of birth, and age. If there are siblings, please provide the same details for each one.
3. Next, fill out the parent or guardian's information, including their name, date of birth, marital status, and contact details. Ensure that the emergency contact name and phone number are also provided.
4. In the 'History of Problem' section, describe your concerns regarding your child. Specify how long these issues have been present and any significant stressors your family may have faced.
5. Complete the symptoms checklist by indicating which symptoms your child is currently experiencing. Note the severity and duration of each symptom for accurate reporting.
6. Provide information about any other agencies involved with your family, especially if there are custody arrangements or if the biological parent is aware of therapy appointments.
7. Fill out the medical history and current medication sections, including any significant medical problems and previous psychiatric treatment. Include details on any alcohol or drug use.
8. If your child has siblings, repeat the steps for documenting their information, including school, age, living situation, and health history.
9. At the end of the form, provide your consent to therapy and respect for your adolescent's privacy by signing and dating where indicated.
10. Finally, review all entered information for accuracy, and save changes. You can then download, print, or share the completed form as necessary.

Take the first step in supporting your child's mental health by completing the TX Nancy Stroud LCSW Psychotherapist Adolescent Intake Form online today.