Get the free Child Therapy Form - Norman Psychology
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Carol Terry Psychological Services, P.C. Carol Terry, Ph.D., Licensed Psychologist 1006 24th Ave N.W., Suite 100 Norman, OK 73069 Phone: (405) 3210303 Fax: (405) 8012846 NEW PATIENT INFORMATION Patient
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How to fill out child therapy form
How to fill out child therapy form
01
To fill out a child therapy form, follow these steps:
02
Start by providing the child's full name, date of birth, and gender.
03
Include the contact information, such as the address, phone number, and email, of both the child and the parent or guardian.
04
Fill in the medical history of the child, including any previous diagnoses, medications, allergies, or medical conditions.
05
Specify the reason for seeking therapy for the child and provide any relevant details or concerns.
06
Describe the child's behavioral/emotional symptoms, developmental milestones, and any observed changes in behavior.
07
Include information about the child's school, grade, and academic performance.
08
Provide a brief family history, including any mental health issues or relevant family dynamics.
09
Mention any previous therapy or counseling the child has received, including the name of the therapist and the duration of treatment.
10
If applicable, include any additional information or concerns that could help the therapist understand the child's needs.
11
Review and double-check the form for accuracy and completeness before submitting it.
Who needs child therapy form?
01
Child therapy forms are needed for individuals who seek therapy services for children.
02
Parents or legal guardians who believe their child could benefit from therapy may need to complete these forms.
03
Medical professionals or therapists who provide child therapy services might also require these forms to gather necessary information about the child's background and needs.
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