Get Canada New Perspectives Counselling Client Intake Form

Completing the Canada New Perspectives Counselling Client Intake Form online is a straightforward process that can help streamline your counselling experience. This guide provides clear and detailed instructions to ensure you fill out the form accurately and efficiently.

Follow the steps to successfully complete the client intake form online.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Enter today's date at the top of the form.
3. Specify your therapist’s name as it appears on the appointment schedule.
4. Select the session type by checking the appropriate box, such as Individual or Couple.
5. Find the section for personal information. Fill in your last name, first name, and middle name.
6. Provide your street address, occupation, and marital status by checking the relevant box.
7. Input your birth date and city of residence, along with your home phone number.
8. Indicate if you are open to receiving messages regarding your home phone.
9. Enter your cell phone number along with your preferences for receiving messages.
10. Provide your employer's name and age.
11. Select your sex by checking the corresponding box.
12. Fill out your postal code and email address, giving permission for New Perspectives to contact you via email.
13. Complete the work phone section and note if you would like to receive messages.
14. Enter the details of an emergency contact person and their relationship to you.
15. Include your family physician's name, address, and phone number.
16. Indicate if you are currently taking any medications, providing details as necessary.
17. Fill out the referral information section by checking the services of interest.
18. Address past counselling experiences by noting whether you have attended counselling previously.
19. Describe the difficulties you are currently facing and list three goals for the counselling process.
20. Indicate how you learned about New Perspectives services.
21. If applicable, complete the anger management or legal involvement section.
22. Fill out insurance information, noting whether you have Extended Health Care Benefit Coverage.
23. Make note of any additional information in the designated section.
24. Review the cancellation policy and ensure you're aware of the terms.
25. Once you have completed all sections, save your changes and choose to download, print, or share the form.

Begin completing the Canada New Perspectives Counselling Client Intake Form online to take the first step towards your counselling journey.