Welcome to Rick Netshiozwi Consultancy.
This confidential intake and assessment form has been developed to assist your counsellor or consultant in understanding your personal circumstances, relationship background, presenting concerns, previous experiences, and expectations before your consultation.
The information you provide will help us prepare appropriately for your session, identify areas requiring attention, and develop a more personalized approach to your counselling or consultancy needs.
Please complete this form honestly, accurately, and independently. If you are attending marriage or couples counselling, each partner is encouraged to complete a separate form unless otherwise instructed.
Some questions may be sensitive or personal. Where a question does not apply to you, indicate "Not Applicable" (N/A). You may discuss particularly sensitive matters privately with your counsellor.
Your information will be handled confidentially, subject to applicable laws, professional obligations, and the limitations explained in the consent section.
