Family Therapy New Client Intake Form
Family Therapy New Client Intake Form
Systems-focused intake for family therapy capturing household members, presenting issues, and each member's perspective on family dynamics.
Primary contact name *
Your answer
Phone
List all household members
What prompted you to seek family therapy?
Your answer
Duration of current issues
< 1 month
1-6 months
6-12 months
1-3 years
Longer
Recent family transitions
Rate overall family functioning
+ 7 more questions
About this template
Systems-focused intake for family therapy capturing household members, presenting issues, and each member's perspective on family dynamics.
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