![]() ![]() Client's Legal History: (ATTACH RELEASES)ġ3. Other Agencies / Systems Client is Involved With or is Receiving Services From, i.e., Dept of Rehab., CalWORKs, ASOC, etc.: (include the name of the agency and primary contact person –ATTACH RELEASES)ħ. ![]() Client’s Current and Significant Past Social Supports, Family Supports, Significant Relationships, Religious and Spiritual Supports/Affiliations:Ħ. Family’s substance use / abuse history:ĥ. Family’s and client’s physical / sexual / emotional abuse history:Ĭ. Family’s current and past psychiatric history:ī. ![]() Occupation and employment history: (present and past, include # of years worked, and reasons for periods of unemployment)Ī. Education history: (include learning problems, school issues ). School currently attending, if applicable: _ Grade: _ī.
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