Intake interview form 2026

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The document is a Standard Triple P Intake Interview Form designed for practitioners to gather comprehensive information about a child and their family. It includes sections on family details, referral sources, diagnostic information, child behavior, factors influencing behavior, obstacles to change, health status, parents' perceptions of the problem, and expectations regarding intervention outcomes. The form aims to assess the child's behavioral issues and the family's dynamics to inform effective parenting strategies.

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Click ‘Get Form’ to open the intake interview form in the editor.
Begin by filling in the 'Family Details' section. Enter the child's name, sex, date of birth, and age. Specify who the child lives with and provide details about both parents, including their names, ages, occupations, marital status, and contact information.
Move on to the 'Referral Source' section. Document the date of referral, agency details, and any comments that may be relevant for context.
In the 'Diagnostic Information' section, describe any previous diagnoses related to the child's behavior along with their sources.
Proceed to 'Child Behaviour'. Provide a detailed description of current problem behaviors and their frequency and duration. Note parenting strategies used to address these behaviors.
Complete sections on 'Factors Influencing Child Behaviour', 'Obstacles to Change', and 'Health Status' by providing comprehensive information as prompted.

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2012	4 Satisfied (34 Votes)

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What is included in an intake form?

Patricia C. Packard Ph.D. Intake Interview Questions. What are stressors in your life currently? Mental and Physical Health History. Previous diagnosis? Any current or prior thoughts of hurting your self? Do any of your immediate family members have history of mental health issues?

What is the purpose of the intake interview?

What is an intake interview? The intake interview is a good measuring point in the recruitment process, where the employer and the applicant get to know each other better. The purpose of the intake interview is to assess whether there is a match between the needs of the organization and the skills of the applicant.

What is the intake interview form?

This intake interview form collects information from a student about any problems they are experiencing and their current situation. It asks about the seriousness and duration of their problems, what caused them, what has been tried to address them, and what type of help the student wants.

What is the purpose of the intake form?

Broadly speaking, intake interviews focus on three assessment areas: (1) presenting problem, (2) psychosocial history, and (3) current situation and functioning. The manner in which clinicians pursue these goals varies greatly.

What to expect in an intake interview?

The Brief Intake/Assessment is the initial meeting with the client during which the case manager gathers information to address the clients immediate needs to encourage his/her engagement and retention in services.

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What is an intake interview?

A client intake form can be physical or digital, and is designed to capture details about the clients needs, preferences, healthy history (if relevant), and any other information that can help you provide a personalized and effective service.

Intake interview form 2026

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