Get the free Couples Intake Form - CALM Program

Couples Initial Intake Form Name: Date: Name of Partner: Relationship Status: (check all that apply) Married Dating Living apart Separated Divorced Living together Length of time in current relationship:

How to fill out couples intake form

How to fill out a couples intake form:

1. Start by providing your basic information, including your names, contact information, and any relevant demographic details such as age, gender, and marital status.
2. Next, indicate the reason for seeking couples therapy or counseling. Be open and honest about your concerns or issues, as this will help the therapist have a better understanding of your situation.
3. Describe your relationship history, including how long you have been together, any previous therapy or counseling experiences, and any significant events or milestones in your relationship.
4. Provide a brief overview of your individual backgrounds, including family dynamics, upbringing, and any personal challenges or trauma that may have an impact on your relationship.
5. Explain your goals and expectations for couples therapy. What do you hope to achieve by attending therapy? Are there any specific issues or areas of conflict you want to address?
6. Be prepared to disclose any mental health concerns, such as anxiety, depression, or substance abuse, that either of you may be experiencing. This information is important for the therapist to develop an effective treatment plan.
7. If applicable, mention any external stressors or challenges that may be affecting your relationship, such as financial difficulties, work-related issues, or family conflicts.
8. Finally, remember to sign and date the couples intake form to indicate that the provided information is true and accurate.

Who needs couples intake form?

1. Couples who are seeking therapy or counseling to address conflicts, improve communication, or enhance their relationship may be required to fill out a couples intake form.
2. Couples who are experiencing significant difficulties in their relationship, such as infidelity, trust issues, or power struggles, can benefit from completing an intake form to facilitate effective therapy sessions.
3. Couples who want to take a proactive approach to their relationship by seeking professional guidance may be asked to complete an intake form as a starting point for therapy.

Remember, every therapist or counseling center may have their own specific intake form requirements, so it's essential to follow their instructions and provide accurate and complete information to ensure the best possible therapeutic experience.

For pdfFiller’s FAQs

What is couples intake form?

Couples intake form is a document used to gather information from couples who are seeking counseling or therapy.

Who is required to file couples intake form?

Couples who are seeking counseling or therapy are required to file couples intake form.

How to fill out couples intake form?

Couples can fill out the intake form by providing accurate and detailed information about their relationship and reasons for seeking counseling.

What is the purpose of couples intake form?

The purpose of couples intake form is to gather essential information about the couple's relationship, goals for counseling, and any issues or concerns they may have.

What information must be reported on couples intake form?

Information such as personal details, relationship history, communication styles, and goals for counseling must be reported on couples intake form.

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