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Couples Intake Form Ben Hase, LPC Thrive Counseling Services DATE ___ Please fill the information out below for each partner. NAME___ GENDER: F___ M___ LastFirstMiddleSOC. SECURITY # ___ DATE OF BIRTH

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How to fill out couples intake form

01

Start with basic information: Include names, contact details, and any relevant personal information.

02

Describe the relationship: Provide information on how long you've been together and any significant milestones.

03

List reasons for seeking help: Identify the issues or challenges you are facing as a couple.

04

Include individual backgrounds: Share personal histories, including family dynamics, previous relationships, and personal challenges.

05

Provide current relationship dynamics: Discuss communication styles, conflict resolution approaches, and emotional connections.

06

Set goals for therapy: Outline what you hope to achieve through counseling.

Who needs couples intake form?

01

Couples who are seeking relationship counseling or therapy.

02

Partners facing challenges in their relationship and looking for guidance.

03

New couples wanting to set a strong foundation for their relationship through professional support.

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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 background, relationship history, and present issues they wish to discuss during counseling sessions.

Who is required to file couples intake form?

Couples seeking therapy or counseling services are typically required to fill out a couples intake form to help the therapist understand their unique situation.

How to fill out couples intake form?

To fill out a couples intake form, both partners should provide accurate information about their personal details, relationship history, and any specific concerns or goals for therapy. It is usually completed before the first session.

What is the purpose of couples intake form?

The purpose of a couples intake form is to collect relevant background information that helps the therapist understand the dynamics of the couple's relationship and to create a tailored therapeutic approach.

What information must be reported on couples intake form?

Information typically required includes personal details of both partners, relationship history, previous counseling experiences, current issues, and goals for therapy.

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