Intake Form - Christian Counseling & Coaching - extraordinarylife 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name, address, and contact details. Ensure accuracy for effective communication.
3. Indicate your marital status and provide relevant dates if applicable. This helps the counseling team understand your background better.
4. Fill out the employment section with your place of work and occupation, along with yearly gross income. This information is crucial for financial assessments.
5. Complete the medical and health information section, detailing any major illnesses or medications you are currently taking. This aids in providing tailored care.
6. If applicable, provide legal authorization for child counseling by checking 'Yes' or 'No' and explaining as needed.
7. Review the policies and procedures section carefully. Initial each item to confirm understanding before signing at the end of the form.

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