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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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