New Client Intake Form

The following is a New Client Intake Form or a basic information form.  It is to be filled out by new clients so that we are provided with the necessary administrative and background information.  

Preferably, clients will fill out this form prior to their first appointment, and at the beginning of that first meeting, the person they/you meet with will review it with them/you.  Besides making the first session more productive, filling it out in advance is generally easier, and some of the  particulars may have to be looked up on documents stored at home.  

To download the form in Microsoft Word format, click on this link:  CnCPC_Intake_Form.doc.

Important Note:  Please note that the standard questions, at the top of page 3, are just that, standard questions that counselling agencies and private practitioners typically include.  We have included this comment to reassure those that are hyper vigilant because of a highly conflicted divorce process and are worried that something might be used against them.  As professionals working systemically, it is useful to have a broad, comprehensive understanding of what factors are influencing a family's environment and dynamics.

_______________________________________________________