Guilford Counseling Intake Interview Form
This file contains the intake interview form for adult and adolescent clients at Guilford Counseling. It aims to collect essential personal history and background information to streamline the first counseling session. Complete this form to ensure your counselor has a comprehensive picture of your situation.
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How do I fill this out?
To fill out this form, carefully read each question and provide your information as accurately as possible. Take your time and answer only the questions you feel comfortable with, skipping any that do not apply to your situation. Your comprehensive responses will help your counselor understand your needs better.
How to fill out the Guilford Counseling Intake Interview Form?
1
Read each question thoroughly.
2
Provide accurate and honest answers.
3
Skip questions that do not apply to you.
4
Review your answers for completeness.
5
Submit the form as instructed.
Who needs the Guilford Counseling Intake Interview Form?
1
Adults seeking counseling services for personal issues.
2
Adolescents needing mental health support.
3
Parents of minors wanting to facilitate therapy.
4
Mental health professionals needing comprehensive client info.
5
Individuals referred for counseling by other professionals.
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What are the instructions for submitting this form?
To submit the completed intake form, please email it to intake@guilfordcounseling.com. You may also fax it to (336) 337-5460. For online submissions, utilize our client portal accessible through the website. Ensure a copy is saved for your records, and consult with your counselor's office if you have any questions.
What are the important dates for this form in 2024 and 2025?
For the year 2024, consider scheduling your first counseling session soon after submitting this form. Ensure all information is updated before January 1st. In 2025, review and update your information annually during your follow-up sessions.
What is the purpose of this form?
The primary purpose of this form is to gather essential information regarding the client’s personal background. This thorough documentation helps counselors better understand the client's situation and needs. By capturing this information, Guilford Counseling is able to tailor their treatment approach effectively.
Tell me about this form and its components and fields line-by-line.
- 1. First Name: Client's first name.
- 2. Last Name: Client's last name.
- 3. Date of Birth: Client's birth date.
- 4. Gender: Client's gender.
- 5. How Were You Referred?: Indicates the referral source.
- 6. Primary Reason For Appointment: Client's reason for seeking counseling.
- 7. Personal History: Questions regarding client’s past experiences.
- 8. Medications: Details about medications the client is taking.
- 9. Relationships: Information about significant personal relationships.
- 10. Legal Status: Current or past legal issues.
- 11. Leisure Activities: Information about hobbies and interests.
- 12. Nutrition: Client's dietary habits.
What happens if I fail to submit this form?
If this form is not submitted, the counseling process may be delayed, affecting the scheduling of your initial session. Additionally, essential background information that could aid in better tailoring of your care will be missing. It is crucial to ensure timely submission for effective treatment.
- Delays in Scheduling: Without submission, your appointment may be postponed.
- Incomplete Background Information: Missing data could hinder personalized care.
- Impact on Treatment Quality: Incomplete forms may affect session efficiency.
How do I know when to use this form?
- 1. First Appointment Preparation: To gather essential client information before the first counseling session.
- 2. Referral Processes: To facilitate the transition of referred clients.
- 3. Tracking Treatment Progress: To be used for subsequent sessions for ongoing evaluations.
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