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Parent Intake Form

This form is used to help us understand your child more from a parent's perspective in our initial meeting:

(Please complete all information prior to our next appointment)

Date: Student Name:

Please answer the following questions in paragraph. Answers can be brief.

1. What are the first words you would use to describe your child?

2. What are your child’s greatest strengths or talents? Feel free to provide anecdotal examples.

3. What are your child’s greatest challenges or weaknesses? Feel free to provide anecdotal examples.

4. In what areas in the last two years has your child grown intellectually, socially, and emotionally? How has those changes defined their character?

5. What type of friends does your child choose? Does he or she have a large group of friends? Does he or she make friends easily?

6. Is your child a risk taker?

7. Is your child assertive or does he/she go with the crowd?

8. Has your child ever been suspended? Has your child ever been arrested?

9. Is your child on any medication that he or she takes regularly?

10. Does your child have an IEP, 504 Plan or receive any special services?

11. Have there been any factors that have had an impact on your child’s high school performance? (Divorce/family illness/death/job loss/relocation/COVID)

12. How has your child coped with these issues? How well did he/she handle virtual learning and lack of school structure?

13. Is your child a reader? If yes, what type of books does he/she like?

14. Do you or your child identify with a religious heritage and/or affiliation? If yes, what role will that play in the college selection process?

15. What kind of learning style/habit you would describe your child?

16. What type of learning environment would best suit your child?

17. Is your child assertive or does he/she go with the crowd?

18. If you were a college admission officer, why would you admit your child? How will your child contribute to campus life?

19. What are your expectations on college financial aid?

20. How involved do you want to be in the essay and application process?

21. What college size, setting, distance you would like your child to choose?

22. Is there anything else you would like to share about your child?