Get the free Client Psychotherapy Intake Form - Ann Landers MFT
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Ann Lander's MFT 314 S. Melrose Dr STE 208, Vista, CA 92081 (760)580 7708, (Fax) (760)7320107 Annlandersmft.com Please provide the following information and answer the questions below. Please note:
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How to fill out client psychotherapy intake form
How to fill out a client psychotherapy intake form?
01
Begin by providing personal information, including your full name, date of birth, contact information, and address.
02
Indicate the reason for seeking therapy and briefly describe your current situation or concerns that prompted you to seek therapy.
03
Include your medical history, including any physical or mental health conditions or medications you are currently taking.
04
Provide details about your family history, including any significant family health or mental health issues.
05
Mention any previous therapy or counseling experiences, including the name of the therapist, duration of therapy, and the reason for ending therapy.
06
Answer questions about your education, occupation, and any significant life events or stressors that may be impacting your current mental health.
07
Discuss your current support system, including people who are important to you and any relationships or social support that you rely on.
08
If applicable, provide information about any legal issues or involvement with the criminal justice system.
09
Lastly, review the form for completeness and accuracy before submitting it to your therapist.
Who needs a client psychotherapy intake form?
01
Individuals seeking psychotherapy or counseling services
02
Hospitals, clinics, or mental health centers offering psychotherapy services
03
Private practices or independent therapists
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