Pre-course Assessment Form – Art Therapy

This form will ask questions about your current parenting and family dynamics. All answers will remain confidential.

Pre-Course Assessment form - Art Therapy

First Name

Last Name

Additional household members

Please add the details of any additional members in your household

Click on the + symbol to add the next household member

First Name	Last Name	Date of birth	Gender	Is this household member of Aboriginal or Torres Strait Islander origin?	Does this household member identify as having a disability, impairment or long-term condition?	Is this household member from a culturally or linguistically diverse background?

Pre-course assessment

The following questions ask about your current parenting and family dynamics, and is used by facilitators to help determine the best way to support you in your parenting role.

Have you attended other parenting courses?

Yes

Did you complete all of the sessions?

Yes

If there was one goal you would like to achieve by attending this group, what would this be/look like?

If other, please specify

Are your children in your care:

Full-time

Part-time

Are you co-parenting?

Yes

Does your child have any diagnosis, disabilities or particular challenges you would like support with?

Do you have links to other parents, support people or services in your life at the moment?

Service support

Family

Friends

Are you currently working with another service provider or community organisation?

Yes

Do you know the location, dates and times?

Yes

No - a copy of the flyer will be emailed to you

We'd love to hear from you - get in touch today

At Central Coast Family Support Services we acknowledge the traditional custodians of this land, the Darkinjung people. We acknowledge the strong kinship networks and positive parenting practices that Aboriginal people have successfully used for tens of thousands of years before us, and continue to use today.

Family Support
Program

Family Support Program

Early Intervention Support

Young Parent
Program

Child & Family
Services

Grandparents & Grandchildren

Child & Family
Services

Children with Additional Needs

Pre-course Assessment Form – Art Therapy

Additional household members

Pre-course assessment

We'd love to hear from you - get in touch today

Family Support Program

Family Support Program

Early Intervention Support

Young Parent Program

Child & Family Services​

Grandparents & Grandchildren

Child & Family Services

Children with Additional Needs

Pre-course Assessment Form – Art Therapy

Additional household members

Pre-course assessment

We'd love to hear from you - get in touch today

Family Support
Program

Young Parent
Program

Child & Family
Services

Child & Family
Services