Intake Questionnaire

The MCPST Intake Questionnaire asks for information about you, the issues that bring you into the clinic and your treatment goals so that we can best provide services for you.

You can download a printable copy of our MCPST Intake Questionnaire.

*This form can be filled out on your computer if you prefer. Be sure to download and save the form to your computer first or you will lose what you typed. Click the down arrow to download the form and open it with your computer’s PDF viewer (such as Adobe Reader) – NOT your internet browser. Fill out the form, save the file and print it to sign and return to us.

Please visit our MCPST Forms page for information about how to use this form if you are a new client.