social work intake form template This is a topic that many people are looking for. newyorkcityvoices.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, newyorkcityvoices.org would like to introduce to you Private Practice Documentation Basics: Intake Form & Free PDF! . Following along are instructions in the video below:
” s up guys. So if you work for an agency or group practice you often often just use whatever our initial intake paperwork that your employer asks you to use how do you know what to include in the initial intake form if you re running your own practice well in this video. I go over some things you might like to consider including in your intake form if you re running your own private practice 34 weeks pregnant breathing. Is not getting easier welcome to private practice skills.
I m dr. Murray fang psychologist and private practice. I post videos offering tools. I learned the hard way about starting and growing private practice.
So. That you don t have to so. Y all. Have been asking me to cover documentation in private practice since pretty much forever.
And i ve been putting it off since you ve been asking me to do it. When i really sat down and thought about it i realized i ve been putting it off because there s way too much information to cover about documentation in one video. So what i decided to do is i m going to break down documentation into a series. So you can look forward to having more videos about documentation come out in the future for today.
We re just going to talk about how to collect your clients. Basic information and the initial intake form. So. What is the intake form this form is included in the initial paperwork packet whether you have clients complete it at home before your first session or maybe they arrive a little bit early and fill it out in the waiting room before you meet the first time.
The initial intake form covers basic information that you need about the client in order to do therapy. And also to gather any logistical information such as what you need in order to build insurance. There s no specific requirements of what you have to ask in this form so it s really up to you to tailor it to your practice and your clients needs when you re developing your intake form. I suggest you run through this list and only include those items that are relevant to your practice.
So it s not about getting as much detail as you possibly can from your clients. But rather focusing in on some key information to give you a quick assessment. Before you get started. There s also a good chance that there may be some items that are relevant to your practice and your specialty.
That you d like to include in this form. Which i don t go over in this with all that said here are some items you might like to consider including in your initial intake form number one identifying information. So you might like to include things. In this section.
Like your clients name date of birth and social security. Number. If you work with minors. This is also a great place to get the identifying information of their legal guardians number.
Two contact information. Now. I do think every intake form needs to ask about some type of contact information. So that you can reach your client.
You might consider asking about phone. Number email address and their snail mail address. And consider adding. A checkbox next to each of these to ask if it s okay for you to utilize that contact method.
And if it s okay to leave a message number three demographic information. So depending on the type of work that you do you may find it helpful to ask questions about demographic information such as gender race sexual orientation faith orientation marital status. Etc. Now for some of you this may actually be triggering information to ask of your client.
In which case. You might refrain from putting it on your intake. Form and simply wait to ask about it. In person number.
Four presenting issues. Now. Even though. Presumably your client has already shared with you their presenting issue during your initial phone screen.
I found that sometimes clients will withhold certain information about their presenting issue sometimes really critical information about it and then just share about it casually in the intake form so i like to include this in my intake. And i also make sure i glance at their answer to this question before we meet face to face. So that i know what to ask about if there s anything relevant that s come up you might also consider whether you d like to ask about the history of this presenting issue things such as onset of symptoms. And anything that they ve done to try to address the issue number five current context.
It might be helpful to get information about employment status income relationship issues. Who is living in the home etc. In order to give you a bit of context surrounding their presenting issue. Number six referral source.
This is a great opportunity for you to collect some data about how this client found you so that you can tailor your marketing strategy. Accordingly number seven mental health history. This is where you might ask if your client has had history of seeking mental health services in the past you might also inquire about whether this client has any known family history of mental health diagnosis number eight physical health of course. We know that physical health overlaps.
So much with mental health. So you might consider asking whether your client has any medical diagnosis as well as whether they re taking any medications at this time. Some people also like to ask for their physicians. Contact information.
And when their most recent physical exam was number nine nine number nine number nine insurance information. If you plan to bill insurance. This is the form where you want to ask all the relevant questions that insurance needs from you in order for you to build them so make sure you get information directly from each insurance panel that you re on as far as what client information they need from you so. That you can have it all consolidated in this one form number ten safety assessment.
Though it s absolutely necessary to do an in person safety risk assessment. It can also be helpful to inquire about risk of self harm suicide and harm to others in the intake form. Sometimes clients are more willing to disclose on paper than they are face to face and number eleven emergency contact information. It s helpful to have an emergency contact in case of emergency and then you can also touch base in person with your client to clarify what merits an emergency and what type of relationship they have with this individual now depending on your style and the clients that you work with you may decide to consolidate key information into a single page form or you may work up a more detailed questionnaire in order to get all the information you can to inform treatment.
Personally. I ve opted for a quick one page form saving additional information for once we meet face to face this is because there s so many barriers that keep clients from scheduling an initial session that i don t want a giant intake packet to be an additional barrier to them so i try to keep my intake packet something that they can complete in less than 10 minutes. Thus. The one page intake form.
I hope you found this video. Helpful as you develop your intake form let me know in the comments. If there s additional items you inquire about and your intake form that i didn t cover in this video. And until next time from one therapist to another.
I wish you well. Today s video is brought to you by therapy. Notes. Calm therapy notes.
Helps with scheduling notes and billing. So. That you can spend more time with your clients and less time on back office paperwork click the link in the description of this video to get two months to try it for free with no commitment isn t that song about a cockroach hope the ice cream truck is back to breathing it s harder i know ” ..
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“Private Practice Documentation Basics: Intake FormnnFree Counseling Intake Form PDF:nhttps://mailchi.mp/ecf67e65aab6/free-counseling-intake-form-pdfnnSign up for TherapyNotes and get two months FREE:nhttps://www.therapynotes.com/r/private%20practice%20skills/nnFREE Guide: Start a Private Practice in Counseling:nhttps://tinyurl.com/y9ek9en8 nnWhen you work for an agency or group practice, you often simply use the intake paperwork your employer asks you to use. But how do you know what questions to include in your intake form when you re running your own practice? In this video I break down some items to consider including when developing your initial intake form.nnThis video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.nnWelcome to Private Practice Skills! I m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don t have to.nnwww.privatepracticeskills.comnFacebook: www.facebook.com/PrivatePracticeSkills/nInsta: PrivatePracticeSkillsnnMusic From Epidemic Sound:nhttps://www.epidemicsound.com/track/QvJEbra5DTnnThis video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.nnHere are some items you might like to consider asking about in your initial intake form:nn1. Identifying Information.nThis includes items like your client s name, date of birth, and social security number. If you work with minors, this is also where you can gather identifying information about their legal guardian(s).nn2. Contact Information. I think every form needs to include this. It s helpful to know your client s contact information so you can reach them. Consider adding a checkbox next to items like their phone number and email to ask if they feel comfortable with you contacting them through this method and if you can leave a message.nn3. Demographic Information. Depending on the work that you do, it may be helpful to gather additional information such as gender, race, marital status. sexual orientation, faith affiliation, etc. If you believe this content could be triggering based on your ideal client, you may consider waiting to meet in person to inquire of this information instead.nn4. Presenting Issues. I ve noticed clients often offer up more information in this section of the intake form than they disclosed to me during the phone screening. I always glance at their answer here before we meet so I inquire about any new items they hadn t brought up initially. You might also like to consider whether you d like to ask about the history of this presenting issue, such as onset of symptoms and how they ve attempted to address it.nn5. Current Context. It can be helpful to ask questions about whether they re currently employed, current income, who s living in the home, relationship concerns, etc. to get a bit of context surrounding their presenting issue.nn6. Referral Source: This is a great opportunity to collect data regarding how clients are finding you so you can tailor your marketing strategy accordingly.nn7. Mental Health History. This is where you might inquire about whether your client has seen any mental health professionals in the past. It s also an option to ask about known family history of mental health diagnoses.nn8. Physical Health. Mental health and physical health overlap so much, so it can be helpful to learn about any known medical diagnoses. You may also consider gathering their physician s contact information, when they had their last physical exam, and whether they are currently taking any medications.nn9. Insurance Information. If you plan to bill insurance, this is the place to gather all relevant information for billing purposes. Be aware of what client information the insurance panels you re on require from you so you can have it all on this one form.nn10. Safety Assessment. It s absolutely necessary to do an in-person safety risk assessment together with your client, but it can also be helpful to inquire about risk of self-harm, suicide, and harm to others in the intake form. Sometimes clients are willing to disclose more on paper than they are in-person.nn11. Emergency Contact Information. In case of emergency, it s helpful to have a point of contact. You can then ask face to face about the client s relationship with this individual and clarify what might merit you reaching out to their emergency contact.nnDepending on your style and the clients you work with, you might consolidate key items into a single-page form, or you might develop a detailed questionnaire to gather extensive information in order to inform treatment.nnA special thank you to TherapyNotes for sponsoring this video. Get two months free!nhttps://www.therapynotes.com/r/private%20practice%20skills/”,
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