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Client Intake Form-06-16-CC doc - conexuscounselling 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out your personal information. Indicate your gender, full name, date of birth, and age. Ensure that all details are accurate for effective communication.
- Provide your contact information including address, home phone, work/alternative number, and email address. If you prefer not to receive messages on these numbers, indicate accordingly.
- Complete the emergency contact section with a name and phone number. This is crucial for any urgent situations.
- Fill in your occupation and education level. If unemployed, briefly describe your situation to give context.
- Detail your family information including siblings and parents' status. This helps in understanding your background better.
- In the medical condition section, circle any relevant health issues you may have experienced. Be honest for accurate support.
- Lastly, articulate the reason for seeking counseling and what changes you wish to achieve. This will guide the therapeutic process effectively.
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Related links
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