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ColourMeIn
Wellbeing

Art Therapy Application and Assessment Form - Adults
 

This form is to be completed by the person seeking art therapy. It helps ensure that therapy is appropriate and tailored to your needs. All information is treated in strict confidence and handled in accordance with HCPC and BAAT guidelines.

Personal Details

Date of Birth
Day
Month
Year
Preferred method of contact

Background Information

Medical and Accessibility Needs

Consent

I confirm that the information provided above is accurate to the best of my knowledge. I understand this information will help the therapist assess the suitability of art therapy for me and plan therapeutic support.
Yes
No
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