Marriage Counseling Intake Form

Marriage Counseling Intake Form Template for Ireland

Create a bespoke document in minutes, or upload and review your own.

4.6 / 5

4.8 / 5

Let's create your Marriage Counseling Intake Form

1. Select your governing law and document type:

2. Enter your key requirements:

3. Create your document to edit, review or download

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

"I need a Marriage Counseling Intake Form for my new Dublin-based private practice opening in March 2025, with emphasis on LGBTQ+ couples and multicultural relationships, including specific sections for cultural sensitivity and gender identity."

Document background

The Marriage Counseling Intake Form is a foundational document used by mental health professionals in Ireland to initiate the counseling relationship with couples seeking therapy. This document is designed to comply with Irish healthcare regulations, the Data Protection Act 2018 (GDPR), and professional counseling standards. It serves multiple purposes: gathering comprehensive client information, assessing relationship dynamics, identifying potential risks or concerns, and establishing the therapeutic contract. The form includes crucial elements such as personal histories, relationship assessment, safety screening, and informed consent, while maintaining sensitivity to cultural and religious factors. It's particularly important for maintaining professional records, ensuring appropriate care planning, and meeting legal requirements for healthcare documentation in Ireland.

Suggested Sections

1. Personal Information: Basic contact details, age, occupation, and preferred contact method for each partner

2. Relationship Status: Current marital status, length of relationship, living arrangements, and previous marriages if applicable

3. Reason for Seeking Counseling: Primary concerns, goals for counseling, and immediate issues that need addressing

4. Medical and Mental Health History: Relevant medical conditions, current medications, previous counseling experiences, and mental health diagnoses

5. Current Relationship Assessment: Rating of relationship satisfaction, main areas of conflict, communication patterns, and shared activities

6. Safety Assessment: Questions regarding domestic violence, substance abuse, and immediate safety concerns

7. Privacy Notice and GDPR Compliance: Information about how personal data will be collected, stored, and processed in compliance with Irish data protection laws

8. Consent and Agreement: Informed consent for counseling, confidentiality terms, and agreement to counseling policies

Optional Sections

1. Children Information: Details about children from current or previous relationships, to be included if clients have children

2. Religious/Cultural Background: Information about religious or cultural factors that may influence the relationship, if relevant to the couple

3. Financial Issues: Section for financial concerns and management if these are identified as significant relationship stressors

4. Extended Family Dynamics: Information about relationships with in-laws and extended family if these are contributing factors to relationship issues

5. Trauma History: Detailed section for past trauma if identified as relevant to current relationship difficulties

6. Substance Use Assessment: Detailed questions about substance use patterns if this has been identified as a concern

Suggested Schedules

1. Schedule A: Fee Structure and Payment Policy: Detailed breakdown of counseling fees, payment terms, and cancellation policy

2. Schedule B: Emergency Contact Information: List of emergency contacts and crisis resources

3. Schedule C: Counseling Services Agreement: Detailed terms and conditions of the counseling relationship

4. Appendix 1: Privacy Policy: Detailed GDPR-compliant privacy policy explaining data handling procedures

5. Appendix 2: Client Rights and Responsibilities: Comprehensive outline of client rights and responsibilities during counseling

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Mental Health Services

Social Services

Professional Services

Family Services

Counseling and Therapy

Medical Practice

Relevant Teams

Clinical Services

Mental Health

Patient Administration

Quality Assurance

Compliance

Records Management

Client Services

Professional Standards

Healthcare Operations

Relevant Roles

Marriage Counselor

Relationship Therapist

Clinical Psychologist

Mental Health Professional

Family Therapist

Healthcare Administrator

Practice Manager

Intake Coordinator

Clinical Director

Counseling Supervisor

GDPR Compliance Officer

Healthcare Records Manager

Find the exact document you need

Online Intake Form For Massage Therapy

GDPR-compliant online intake form for massage therapy services in Ireland, combining medical screening and legal agreement elements.

��������Ƶ

How ��������Ƶ reduced drafting time by 75% for a legal firm

Let's create your Marriage Counseling Intake Form

Authors

Alex Denne

Find the exact document you need

Online Intake Form For Massage Therapy

Chair Massage Consent Form

New Patient Intake Form

Physical Therapy Intake Form

Health Intake Form

Counseling Intake Form

Project Intake Form

Accounting Client Intake Form

Real Estate Client Intake Form

Marketing Client Intake Form

Initial Intake Form

Business Client Intake Form

Veterinary Intake Form

Massage Consent Form

Hypnotherapy Client Intake Form

Biopsychosocial Intake Form

Marriage Counseling Intake Form

Consulting Intake Form

Salon Client Intake Form

Client Intake Form

Lead Intake Form

Vendor Intake Form

Intake Assessment Form

Clinical Intake Form

Procurement Intake Form

Patient Intake Form

Download our whitepaper on the future of AI in Legal

�ұ�Ծ���’s Security Promise

Your documents are private:

Your documents are protected:

Organizational security

Innovation in privacy:

Want to know more?

Use Cases

��Ƶ

How ��Ƶ reduced drafting time by 75% for a legal firm

�ұ�Ծ��’s Security Promise