11. Child Intake Form

This document provides an example of the Child Initial Intake Form used by Norwest Wellbeing. It’s designed to give you an overview of the information we collect during the intake process for child therapy services.

Purpose of this Example:

1. To familiarize you with the types of questions asked in our intake process.
2. To help you prepare the information you might need when filling out the actual form.
3. To demonstrate the comprehensive nature of our approach to understanding your child’s needs.

Please note:

• This is a sample form and not for actual submission.
• The actual form will be provided to you directly when you’re ready to begin the intake process.
• All questions are carefully chosen to help us tailor our therapy approach to your child’s specific needs.

The form is divided into several sections, each focusing on different aspects of your child’s life and current challenges. By reviewing this example, you can gather relevant information in advance, ensuring a smoother and more efficient intake process when you’re ready to begin.

If you have any questions about the intake process or the information requested, please don’t hesitate to contact us. We’re here to support you every step of the way.