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Counseling Intake Interview Questions

This intake form collects information from a new counseling client, including their name, date of birth, and reasons for seeking counseling. It asks the client to describe in their own words why they are seeking help and what they hope to gain. It also requests information on any relevant family or personal history of health, mental health, substance abuse, or other issues.

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Becca Bolo Delos Santos
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52 views1 page

Counseling Intake Interview Questions

This intake form collects information from a new counseling client, including their name, date of birth, and reasons for seeking counseling. It asks the client to describe in their own words why they are seeking help and what they hope to gain. It also requests information on any relevant family or personal history of health, mental health, substance abuse, or other issues.

Uploaded by

Becca Bolo Delos Santos
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Intake Interview Questions

SCC-Guidance Center

INTAKE INTERVIEW QUESTIONS:


These questions and the answers you provide may likely increase my ability to help you.
Client Name:__________________________________

Date: __________________

Age: _______
In your own words, why are you seeking counseling at this time?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
In your own words, what do you hope to gain after counseling session?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
What do you see as your strengths?
_______________________________________________________________________________________
_______________________________________________________________________________________
__________________________________________
If you or any of your family has a history of any of the following, please indicate and briefly describe:
Health problems, Mental health problems, Substance abuse problems, History of abuse (physical, emotional,
or sexual), Legal problems, Economic problems, Occupational problems and Family problems

SCC-Guidance Center INTAKE INTERVIEW QUESTIONS: These questions and the answers you provide may likely increase my ability to

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