Couples Therapy New Client Joint Intake Form
Couples Therapy New Client Joint Intake Form
Joint intake for couples covering relationship history, current stressors, communication patterns, and therapy goals from each partner.
Each partner should answer for themselves. Answers are confidential between you and your therapist.
Partner A full name *
Your answer
Partner A email
Partner A phone
Partner B full name *
Your answer
Partner B email
Partner B phone
Relationship status
Dating
Engaged
Married
Cohabitating
Separated
+ 14 more questions
About this template
Joint intake for couples covering relationship history, current stressors, communication patterns, and therapy goals from each partner.
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