心理咨询来访者登记表

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1、来访者登记表下面需要填写的内容为您一般资料，望如实填写。您并且不必担心内容被泄漏，因为你的登记表内容是被严格保密的。编号：姓名：性别：年龄：　民族婚姻状况　现住地： 职业：学历：籍贯：  通讯地址　电话 来访原因（详细内容）　  当前问题的历史　医疗及及心理咨询史 日期                时间 咨询师初诊接待记录表（首次）姓名：性别：年龄：编号：日期： 来访者对其不适的主观描述（S） 咨询师对求助者的服饰、外貌等的描述（O）　咨询师对咨询过程的要点记录（A）　  本次咨询作业和下次咨询的计划（

2、P）咨询师签字：第（）次咨询记录表来访者姓名：日期：会谈次数 编号： 是否施测心理测验及其结果本次咨询讨论主题本次咨询师咨询目的 本次会谈要点 家庭作业　      下次会谈计划主题 咨询师本次咨询的感触及内心活动　                会谈接连作业表1．上个会谈我们讨论了哪些重要的问题？你从中学到了什么？（1－3句话）                                                                                         

3、                                                                                                                                                                               2．上个会谈有什么事情使你烦恼？你有什么事不愿讲吗？                                                      

4、                                                                                                                                                                                                                                                               

5、                                   3．你的这一周怎么样？与其他周相比，你这一周的心境如何？（1－3句话）                                                                                                                                                                                         

6、                                                                               4．这周有无什么重要的事发生并需要讨论？（1－3句话）                                                                                                                                                     

7、                                                                                                                   5．你想要将什么问题列入日程？（1－3句话）                                                                                                                      

8、                                                                                                                                                  6．你做了或没做什么家庭作业？