Child intake assessment form
Your honesty is important and your answers will help us to plan the best treatment options with and for you, while providing the best possible care for you and your child(ren).
Before you start, our Privacy Policy tells you how we will use your information. Please view it here.
We’ll keep your information private as far as possible, however, in accordance with state and federal legislation, it may become necessary that we disclose certain information to health providers and government departments for the wellbeing of you and your children.
A separate form must be completed for each child.