Get the free Couples Intake Form

This form collects personal and relational information from couples seeking counseling services at LifeCare Counseling. It includes sections on personal information, billing details, insurance, scheduling preferences, relational history, medical history, mental health history, and counseling needs and goals.

How to fill out couples intake form

How to fill out couples intake form

1. Start with personal information: Fill out the full names, contact details, and date of birth for both partners.
2. Provide relationship details: Indicate the nature of the relationship, how long you have been together, and if there are any prior relationships.
3. Identify reasons for seeking help: Clearly state the issues or challenges that brought you to seek counseling.
4. Include family background: Share relevant information about family dynamics, children from previous relationships, and any significant family events.
5. Detail individual histories: Each partner should provide information about their personal history, including significant past relationships and life experiences.
6. Describe communication styles: Note any patterns or styles of communication that are present in the relationship.
7. List goals for counseling: Articulate what you hope to achieve through the counseling process.

Who needs couples intake form?

1. Couples who are experiencing challenges in their relationship.
2. Individuals seeking to improve their relationship dynamics.
3. Partners contemplating marriage or a long-term commitment.
4. Couples preparing for premarital counseling.
5. Those looking to enhance communication and intimacy within the relationship.

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What is couples intake form?

A couples intake form is a document used by therapists or counselors to gather information about a couple's relationship, history, and specific issues they may want to address during therapy.

Who is required to file couples intake form?

Couples seeking therapy or counseling services are typically required to fill out a couples intake form.

How to fill out couples intake form?

To fill out a couples intake form, each partner should provide personal information, relationship history, and details regarding specific concerns or goals for therapy. It's important to answer questions honestly and thoroughly.

What is the purpose of couples intake form?

The purpose of the couples intake form is to help the therapist understand the couple's dynamics, identify areas of conflict, and develop a suitable treatment plan.

What information must be reported on couples intake form?

Information typically required includes basic personal details, relationship history, significant events, current issues, goals for therapy, and any relevant medical or psychological history.