Get Christian Counselling Services Client Intake Form 2017-2025

Completing the Christian Counselling Services Client Intake Form online is an important first step in your counselling journey. This guide is designed to provide clear, step-by-step instructions to help you fill out the form accurately and thoroughly.

Follow the steps to fill out the form with confidence.

1. Click ‘Get Form’ button to obtain the intake form and open it in the provided editor.
2. Begin by providing your general information. Fill in your last name, first name, birth date, and age. Make sure to include your street address, city, province, and postal code. If you have a guardian or parent and are under 18, please include their information as well.
3. Next, indicate your employment and education status. Select one of the employment options — full-time, part-time, self-employed, or unemployed. Specify your occupation and length of employment. Additionally, circle the highest level of education you have completed.
4. In the family information section, outline your current relationship status by circling the appropriate option. If applicable, provide the name of your spouse or partner, anniversary date, number of years married, and the names and ages of your children. If you have experienced any loss of children, include the details as requested.
5. Define the concerns that brought you to counselling. Clearly articulate your reason for seeking counselling and your desired outcomes from the experience.
6. Indicate any thoughts or feelings that may be concerning you by checking any applicable statements related to self-harm or frequent negative thoughts.
7. Circle any conditions that are currently a concern for you from the provided list, such as anxiety, depression, or relationship issues.
8. In the medical and psychological history section, provide your physician's name and address, along with the date of your last medical examination. Detail any current physical illnesses or symptoms and list your current medications, including name, dosage, and date prescribed.
9. Answer questions regarding any past or current help for drug or alcohol dependency for yourself or family members, and detail if you have received counselling before or are currently seeing a counsellor elsewhere.
10. Lastly, provide information on how you heard about Christian Counselling Services and your reason for choosing them. Ensure to include your religious preference and the name of your pastor or religious leader if applicable.
11. Once you have completed all sections, review your information for accuracy. Then save changes, and choose to download, print, or share the form as needed.

Begin your counselling journey by completing the Christian Counselling Services Client Intake Form online today.