What is your definition of family (who is included)? Who might be included in other people’s definitions that you do not include in yours and why? Do you think that if your parents, grandparents, and great-grandparents (maybe not yours specifically, but others who grew up during that time) were asked this question when they were your age there would be differences, and why?
Intake Assessment Template: Case of __________ Intake Date: Instruction:
Intake Assessment Template: Case of __________ Intake Date: Instruction: Respond to each applicable element (below). Use complete sentences and explain or describe accurately. Identifying/demographic data: Chief complaint/presenting problem: History of present illness: Past psychiatric history (evaluate any past diagnosis): Substance use history: Past medical history: Family history (including medical and