Get Tn Sarah M. Torti Lpc-mhsp Client Intake Form 2012-2025

Filling out the TN Sarah M. Torti LPC-MHSP Client Intake Form online is an important step in your counseling journey. This guide provides comprehensive instructions and support to help you complete each section accurately and efficiently, ensuring that the information captured reflects your needs and circumstances.

Follow the steps to fill out the form online:

1. Click the ‘Get Form’ button to access the form and open it for completion.
2. Begin with the 'Client Information' section. Enter your name, date of intake, gender, age, date of birth, address, contact information, and employment details. Ensure that all fields are completed accurately.
3. Next, fill out the 'Marital Status' field. Indicate your current marital status and provide details about your spouse or partner, if applicable.
4. In the 'Emergency Contact' section, list someone who can be reached in case of an emergency, including their relationship to you and contact information.
5. Complete the 'Financial Responsibility' section to indicate who will be responsible for payment of services. Provide the name and address of the responsible party, if different from yourself.
6. Move to the 'Family Dynamics' section, and outline your family relationships, including significant others and any important family events that may impact your counseling.
7. In the 'Counseling History' section, indicate if you have previously been involved in counseling, detail any mental health hospitalizations, and provide any history of mental illness in your family.
8. Fill out the 'Current Symptoms Checklist' to the best of your ability, rating the intensity of your symptoms based on the provided scale.
9. In the 'Substance Use History' section, note any substance use, including frequency, age of first and last use, and whether you have sought help for substance abuse.
10. Complete the 'Medical History' by listing your primary care provider, current medications, significant health issues, and any past surgeries or hospitalizations.
11. Identify your treatment goals in the corresponding section, detailing the areas you hope to work on during counseling.
12. Review the 'Client Notification of Privacy Rights,' ensuring understanding of your rights regarding privacy and consent. Sign to indicate you have read it.
13. Lastly, ensure you review any appointment and fee agreements, sign where required, and download, print, or save your completed intake form as needed.

Start your counseling journey by filling out the TN Sarah M. Torti LPC-MHSP Client Intake Form online today.