Adolescent Psychosocial Asessment Page 14
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14CURRENT NEEDS/GOALS
What do you feel is your child’s biggest need right now? ____________________________________________
What do you most hope to gain from coming to counseling? _________________________________________
If you were to pick three goals to work on, what would they be?
Goal 1: _______________________________________________________________________________
Goal 2: _______________________________________________________________________________
Goal 3: _______________________________________________________________________________
What else would you like for us to be aware of?
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
INDIVIDUAL(S) COMPLETING ASSESSMENT
Printed Name (primary person) _____________________________________ Date: _____________________
Signature _________________________________________
Relationship to child _______________________________________
Printed Name (secondary person) ___________________________________ Date: _____________________
Signature _________________________________________
Relationship to child _______________________________________
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