Client intake information form 2026

1. Click ‘Get Form’ to open the Client Intake Information Form in the editor.
2. Begin by filling out the Medical/Psychological History section. If you have been hospitalized for a mental illness or substance dependency, select 'Yes' and provide details in the space provided.
3. In the Problem Definition section, clearly state your reason for seeking help. Check all applicable conditions that may be affecting you or your child from the list provided.
4. Reflect on what you would like to achieve through counseling and write your goals in the designated area.
5. Finally, sign and date the Acknowledgement section to confirm that all information is accurate. Ensure both signatures are provided if applicable.

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