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Why are you seeking help now?
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What was life like as you were growing up, both at home and in school?
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Please give more details about the issue you named above:
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What significant educational and work/volunteer experiences have you had?
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Have you ever experienced similar or other mental health symptoms before?
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Do you have any current or prior legal issues?
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Has anyone in your family ever experienced mental health or substance use issues?
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Who is in your family? What is your relationship with them like?
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Do you have any current or prior medical issues?
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What spiritual practices and cultural influences are important to you?
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Are you currently taking any medications - either prescribed or over-the-counter?
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What social activities and relationships do you engage in?
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If yes to the above, please name any currrent medications and doages
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What strengths and abilities are you bringing to sessions? What needs or preferences do you have that will help us be successful?
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Do you now, or have you ever, used alcohol, tobacco, recreational drugs, or prescription medication other than as prescribed?
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What else is important to know about you?
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