Family Therapy Intake and Assessment Form

A comprehensive, clinician-designed Family Therapy Intake & Systemic Assessment — built for therapists, social workers, and counsellors who work with families using a relational or systemic approach.

Developed by an experienced registered mental health social worker, family therapist and psychotherapist with a systemic and trauma-informed lens, covering everything from genogram mapping to intergenerational patterns, provisional hypothesis, and risk assessment.

Completely unbranded. 

📋 WHAT'S INCLUDED

✔ 9 Page PDF 

✔ Family composition table (6 members, attendance, living situation)

✔ Individual perspectives section — captures each member's view of the presenting concern

✔ Relational & systemic observations — roles, alliances, communication patterns, attachment themes

✔ Genogram drawing space with notation prompt (3 generations)

✔ Intergenerational patterns section

✔ Provisional systemic hypothesis — formulation space rarely found in other templates

✔ Safety & risk — DFV, child safety, and individual risk assessed separately

✔ Consent, confidentiality & logistics

✔ Supervision flags section

👩‍⚕️ IDEAL FOR

Family therapists and systemic practitioners

Social workers in private or community practice

Child and adolescent therapists

Couples and relationship counsellors

School counsellors working with family systems

Allied health professionals doing family work