Individual Pre-Counselling Information Form

Thank you for choosing Paraklesis for your counselling needs. Making an appointment is the beginning step of moving towards wellness - completing this pre-counselling information form, is another milepost of committing to your counselling and wellbeing.

This form is presented to you to gather pre-counselling information for your upcoming counselling sessions. It will expedite the counselling and help me serve and assist you more effectively.

Respond to the questions according to the way you have been feeling over the past several weeks/months. Complete each section and question thoughtfully, honestly and as completely as you can.

Please allow enough time to complete this inventory. It is a multi-page form and you will have to complete all the steps before submitting the form. Fields marked with an " * " (asterisk) are required fields and you will not be able to proceed to next step or to submit the form without completing those.

All information is provided voluntarily, but you are encouraged to share as much detail as what you are comfortable with. Please provide all the relevant information applicable to your counselling concern.

All information will be confidential (review the Paraklesis Confidentiality & Privacy Policy Online).

With your permission portions of the inventory will be discussed with you during the counselling sessions. Issues, concerns and strengths will be identified and clarified, and a collaborative treatment plan will be formulated. 

Proceed and complete the form below.

Thank you for your cooperation - completing this form is a vital part of your counselling journey. 

Dr Mervin van der Spuy

Individual Pre-Counselling Information Form

Please first login to the Paraklesis Website or register on the website (Login/Register Icon on to right of page). Then return and complete this form. Thank You.