pre-counseling questions form:

    PRE-COUNSELING QUESTIONS

    Please take some time to think through what has been happening in your life that brings you to counseling. This section will help us get to know your current situation better, in order to match you with a counselor and/or provide the best help. Use the following questions as a guide to journal about what is going on in your life and heart.

COUNSELING INFORMATION FORM:

Please be aware that there are no wrong or right answers to the following questions. Your honest answers will help us to know and serve you better.

    PERSONAL INFORMATION

    MARRIAGE AND FAMILY INFORMATION

    HEALTH INFORMATION
    HOW MUCH OF THE FOLLOWING TYPE OF BEVERAGES DO YOU CONSUME DAILY OR WEEKLY?

    BACKGROUND INFORMATION

    Please answer these background questions to the best of your ability, so we might minister to you more sensitively and wisely. These questions are not meant to imply: 1) that we cannot now know God as Father, sovereign, good and sufficient because of our past, 2) that God cannot use our past for good, 3) that our past is our identity nor, 4) that we are determined by our past.

    Other and Later Life:

    SPIRITUAL LIFE INFORMATION:

    PROBLEM CHECK LIST

    Please mark 1-3 on all that apply (1=Mild, 2=Moderate, 3=Severe).

    PRE-COUNSELING QUESTIONS

    Please take some time to think through what has been happening in your life that brings you to counseling. This section will help us get to know your current situation better, in order to match you with a counselor and/or provide the best help. Use the following questions as a guide to journal about what is going on in your life and heart.
4700 Allen Road  |  Allen Park, MI  48101  |  313.504.HOPE  |  [email protected]
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