Pre-Session Client Information - Child / Minor

IMPORTANT: This form is to be completed by the minor or child in his or her own words. Fill as much as you can but if you are not sure what to write in some of the questions, that is OK. We can talk more when we meet up. Your parents will be sent a separate set of questions so they can tell me what they think and I need some information from them about your health and background that will help me understand your difficulty better. You need to know that whatever you tell me is confidential between us, unless your safety is under threat. I will always discuss this with you first.

*** PERSONAL DETAILS AND HISTORY

*** EXPERIENCE AND EXPECTATIONS

Are you here of your own choice?




*** PAST AND CURRENT THERAPY HISTORY

*** MEDICAL HISTORY

*** PERSONAL AND FAMILY BACKGROUND

*** RELIGIOUS OR SPIRITUAL BACKGROUND

*** ADDITIONAL INFORMATION

 

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