Intake and Informed Consent Final Copy.doc 2026

1. Click ‘Get Form’ to open the Intake and Informed Consent Final Copy.doc in the editor.
2. Begin by entering the date, ID number, and referral source at the top of the form. This information helps us track your intake process.
3. Fill in your personal details including name, date of birth, age, mailing address, and contact numbers. Ensure you indicate whether we can leave messages at these numbers.
4. Complete the academic information section by providing your classification, hours attempted this semester, overall GPA, expected graduation date, major, and probable occupation.
5. In the counseling concerns section, describe what brings you to counseling and rate the severity of your problem. This helps us understand your needs better.
6. Answer questions regarding past counseling experiences and any current suicidal thoughts. Your honesty is crucial for effective support.
7. Assess your physical health and lifestyle habits such as exercise frequency and sleep patterns. This information is vital for a holistic approach to your care.
8. Review all sections for completeness before saving or printing the document to bring to your first appointment.

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