Get the free Brookside Counseling Intake Form - cdmarriagecounseling.com

Brookside Counseling Intake Form Name: (Last) (First) (Middle Initial) Name of parent/guardian(If under 18 years): (Last) Birthdate: / / (First) / Age: (Middle Initial) Gender Male Female Address:

How to fill out brookside counseling intake form

How to fill out brookside counseling intake form:

1. Start by providing your full name, date of birth, and contact information.
2. Next, answer questions regarding your current address, marital status, and emergency contact.
3. Provide information about your healthcare provider, including their name, contact information, and any current medications you are taking.
4. Answer questions about your history of counseling or therapy, including any previous providers or treatments.
5. Provide information about your current mental health concerns, including any symptoms or challenges you are experiencing.
6. Answer questions about your family history of mental health, including any known disorders or conditions.
7. Finally, sign and date the form to acknowledge that all information provided is accurate and complete.

Who needs brookside counseling intake form?

1. Individuals seeking counseling services at Brookside Counseling Center.
2. Individuals who are new to Brookside Counseling Center and have never filled out an intake form before.
3. Individuals who have previously received counseling services at Brookside Counseling Center but need to update their information.

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What is brookside counseling intake form?

Brookside counseling intake form is a document that collects relevant information about a new client before their first counseling session.

Who is required to file brookside counseling intake form?

New clients who are seeking counseling services at Brookside counseling are required to fill out the intake form.

How to fill out brookside counseling intake form?

The intake form can be filled out either online or in person at the counseling center. Clients are required to provide personal information, contact details, medical history, and reason for seeking counseling.

What is the purpose of brookside counseling intake form?

The purpose of the intake form is to gather necessary information about the client's background, current situation, and mental health needs in order to provide effective counseling services.

What information must be reported on brookside counseling intake form?

The intake form typically requires information such as name, address, phone number, emergency contacts, medical history, current medications, mental health symptoms, and reason for seeking counseling.