Personal History Checklist™ for Adults

Facilitates completion of a personal history

Details

Purpose

Facilitates completion of personal history during intake

Authors

John A. Schinka, PhD

Administration Formats

Print

Additional Details

Gather a Client's Personal History to Aid in the Intake Process

Checklist for Adults obtains a personal history of those over 18.

Features and benefits

  • A 119-item survey.
  • Gathers a personal history of adult clients.
  • Reviews the presenting problem and provides information about the client’s personal information; background history; developmental history; family history; educational history; occupational history; and health, habits, and behavior.
  • Typically used for intake or to provide the client’s personal history and background in written documentation.
For licensing information, please contact PAR Customer Support.
Photo of Personal History Checklist for Adults | PAR
Age Range 18 years to 60 years
Admin Time Varies
Qualification Level A

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