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Pediatric Mental Health Care Services - NSU Health

Pediatric Mental Health Care Services - NSU Health 2025

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4.5 out of 5

62 votes

The document outlines the intake process and policies for Central Iowa Psychological Services, emphasizing compassionate care and comprehensive evaluation for adult clients seeking therapy. It includes sections on personal data collection, medical and psychological history, current concerns, treatment agreements, confidentiality rights, payment policies, and client rights under HIPAA. The document aims to inform clients about their responsibilities, the therapeutic process, potential risks and benefits of therapy, and the importance of collaboration in achieving mental health goals.

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Click ‘Get Form’ to open the Pediatric Mental Health Care Services - NSU Health document in the editor.
Begin by filling out the 'Personal Data' section. Enter your name, date, address, age, date of birth, and gender. Ensure all fields are completed accurately.
Proceed to the 'Main Concerns' section. List your primary concerns for therapy and rate their severity on a scale from 1 to 10. This helps your therapist understand your needs better.
In the 'Medical History' section, indicate any serious medical conditions and provide details about medications you are currently taking. This information is crucial for your treatment plan.
Complete the 'Current Stressful Events' and 'Family of Origin History' sections by providing relevant details that may impact your mental health.
Review all entered information for accuracy before submitting the form. Use our platform's features to save or print a copy for your records.

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Versions	Form popularity	Fillable & printable
2018	4.5 Satisfied (62 Votes)
2014	4 Satisfied (46 Votes)

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