Follow the steps to successfully complete the online form.

1. Press the ‘Get Form’ button to retrieve the document, and open it in your preferred editor.
2. Begin with the personal data section, entering your name, date, address, age, date of birth, and gender. Be sure to fill out the home, cell, and work phone numbers as well as the email address, specifying if you would like messages left.
3. Continue to provide educational background, occupation, marital status, current living situation, and information about your spouse or partner's occupation, and the number and ages of your children.
4. Specify your spirituality or religious affiliation and indicate any military service. Provide information regarding your ethnicity by marking all that apply.
5. Identify an emergency contact and their phone number. This section helps prepare for any unforeseen circumstances.
6. Move to the main concerns section, outlining the significant issues you wish to address in therapy and rate their severity on a scale from 1 to 10.
7. Provide a brief description of your motivations for seeking treatment at this time.
8. In the medical history section, indicate any serious medical conditions and your vaccination status. Rate your overall health and provide your primary care physician's details.
9. List any medications you are currently taking, any allergies, and any significant medical incidents in your past, including hospitalizations.
10. Complete the prior mental health or substance abuse treatment section, indicating if you have received any previous mental health services.
11. Describe current stressful events in your life, including any experiences of domestic violence or significant life events related to grief or loss.
12. Assess your daily functioning and lifelong functioning by completing the relevant sections about time spent on various activities.
13. Review the personal and family medical history section, marking any relevant medical conditions experienced by yourself or family members.
14. Complete any necessary financial information, particularly if you will be using insurance. Ensure you provide the required details regarding the policyholder.
15. Final step: Once the form is completed, you can save changes, download, print, or share the form as necessary.

Complete your IA Psychological History Initial Information/Evaluation for Adults online today for a smooth intake process.