This form gives us basic contact information about you, your insurance, how you prefer to be contacted, our basic policies, which are listed in the "Informed Consent for Treatment" form. BIOPSYCHOSOCIAL HISTORY FORM
It is essential that ALL new patients individually fill out a Biopsychosocial History Form. This form gives us essential background data which is generally necessary in order to provide effective treatment. Not filling in sections of the form limits our ability to help you.
This is not necessarily a form required of a new client. However, because everything you say and do at Covenant Counseling Services is protected by strict confidentiality, this form is necessary in order to give us permission to acknowledge that you are a client or to discuss any aspect of your case with anyone, including family members, school guidance counselors, other mental health professionals, attorneys, probation officers, etc. Since each one of our clinical staff have their name affixed to a form, please click on the form of your therapist:
This form is necessary in the situation where the particular custody situation of a minor child may be an impediment to both biological parents agreeing on the necessity of counseling for that child.