Get the free DBT Intake Form - Therapy Connections

Phone: 7632700054 FAX: 7632086371 DEBT Intake Form Referral Source: Phone: Date: Client Name: DOB: Age: Address: Parent Name(s): Phone: Address: Same as parent Custody issues: Additional professionals

How to fill out dbt intake form

How to fill out a DBT intake form:

1. Begin by reading the instructions carefully. Make sure you understand all the requirements and sections of the form.
2. Start with the personal information section. Provide accurate details such as your name, date of birth, address, and contact information.
3. Move on to the medical history section. Fill in any relevant information about your past and current medical conditions, medications you are taking, and any allergies or sensitivities you have.
4. Next, complete the mental health history section. Include details about any previous diagnoses, treatments, and therapies you have undergone. Also, mention any hospitalizations or significant life events that may be relevant to your mental health.
5. In the therapy history section, provide information about any previous therapy experiences and the outcomes you have achieved. Include details about the types of therapy you have received, the duration, and the goals you were working towards.
6. Answer the questions in the behavioral patterns section. This section aims to understand any self-destructive behaviors, substance use, or other harmful patterns you may engage in. Be honest and provide as much detail as possible.
7. If there is a section for current goals or concerns, specify your primary concerns and the goals you hope to achieve through DBT therapy. This will help the therapist understand your priorities and tailor the treatment accordingly.
8. Finally, review your form for accuracy and completeness before submitting it. Double-check that you have filled in all the required fields and have not missed any important information.

Who needs a DBT intake form?

1. Individuals seeking Dialectical Behavior Therapy (DBT) may need to fill out a DBT intake form. DBT is a type of therapy that focuses on teaching skills to manage emotions, improve relationships, and cope with distress effectively.
2. People who have been referred to DBT by mental health professionals, such as psychiatrists or therapists, may need to complete an intake form as part of the assessment and intake process.
3. Individuals who are considering starting DBT as a form of therapy for managing emotional dysregulation, borderline personality disorder, or other mental health issues may also be required to fill out a DBT intake form.

For pdfFiller’s FAQs

What is dbt intake form?

The dbt intake form is a document used to collect detailed information about a new patient seeking Dialectical Behavior Therapy (DBT) services.

Who is required to file dbt intake form?

New patients seeking Dialectical Behavior Therapy (DBT) services are required to file the dbt intake form.

How to fill out dbt intake form?

The dbt intake form can be filled out by providing accurate information about personal details, medical history, and reasons for seeking DBT services.

What is the purpose of dbt intake form?

The purpose of the dbt intake form is to gather necessary information to understand the patient's background, needs, and goals for DBT therapy.

What information must be reported on dbt intake form?

Information such as personal details, medical history, mental health concerns, and reasons for seeking DBT therapy must be reported on the dbt intake form.

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