Intake Assessment
May 9th, 2022
Intake/Assessment Notes- For this, create an intake form that you would use in your initial meeting with the family. You will need to document the specific phrases and/or questions that you would use in order to obtain the information needed to work with the family. Be mindful of the language used with the client during the intake.
• Intake Notes: Your intake notes should include questions or statements that collect information on the following as well as any additional information you feel is relevant:
o Details related to each member of the family (age, sex, grade in school, etc.)
o Family Structure
o Employment status
o Family history related to marital status, moving, work, etc
o Background with Human Services
o Current life stressors (work, financial difficulties, substance abuse, etc.)
o Current needs the client has
• Intake Notes: Your intake notes should include questions or statements that collect information on the following as well as any additional information you feel is relevant:
o Details related to each member of the family (age, sex, grade in school, etc.)
o Family Structure
o Employment status
o Family history related to marital status, moving, work, etc
o Background with Human Services
o Current life stressors (work, financial difficulties, substance abuse, etc.)
o Current needs the client has
• Assessment Notes: Your assessment notes should document the information you know about the family from the referral. Although the assessment notes will more than likely not be seen by the client, it is important that the language used maintains professionalism and objectivity. You will want to include the following as well as any additional information you feel is relevant:
o Note who made the referral
o Identify the reasons for referral
o Present the issues that you might address
o Identify potential avenues of resources to explore
