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Christian Counseling Centers of Indiana, Inc.
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 Assessments & Inventories for Individuals 
IDENTIFYING INFORMATION FORM 

In order for us to get to know you more thoroughly and in order to avoid missing any areas that could be of concern to us in dealing with your issues, you may be asked to complete the Identifying Information Form. We will then review it together in session for further detail.

If your counselor has asked you to complete the Identifying Information Form

Click Here To Begin
PERSONAL INVENTORY 

Christian Counseling Centers of Indiana is dedicated to providing services for the church and the community at large. Our mission is to bring people to maturity in Christ Jesus and help them grow in maturity in Christ Jesus. Bringing people to maturity in Christ Jesus means we help them grow in several areas.

    • His or her needs physically.
    • His or her mental or cognitive domain.
    • His or her emotional well being of the individual.
    • His or her experiential wisdom.
    • His or her spiritual guidance and the influence of the Holy Spirit.
    • His or her relationships.

By examining these areas of your life, you can determine if you are living a life of Christian maturity.

If your counselor has asked you to complete the Personal Inventory

Click Here To Begin
MOOD TRACKER 

The Psych Central Mood Tracker is a powerful and easy-to-use tool that allows you to track your emotions -- or moods -- on a regular basis. Why would you want to do this? By tracking your moods, you may be able to determine (with or without the help of a therapist) situations or times that your mood goes up or down. Such situations are sometimes called triggers. For instance, if you notice you get depressed everytime you visit your parents, that's important information that you can use to help you understand yourself better.

To Begin the Mood Tracker

Click Here to Begin
INTAKE FORMS 

If this is your first appointment, please print print these forms off to fill in during your visit. 

If your counselor has asked you to complete the Intake Forms

Click Here To Begin
DISCIPLESHIP INVENTORY 

It is our contention that when Jesus called his twelve disciples he called one of each personality type. He was the perfect personality and could work with all the different personality types. In order for us to help you determine your personality profile you may be asked to complete the Discipleship Inventory.

If your counselor has asked you to complete the Discipleship Inventory

Click Here To Begin
MY CURRENT SYMPTOMS 

As we get started and periodically throughout the time we work together we need to look at your symptomology to see if you have any symptoms we need to address in treatment or to be sure your symptoms if there are any are improving. We will chart your progress as we work together. One of the ways we note improvement is symptom reduction. However, as we start and when we check up in order to ensure accuracy of symptoms we need your input as to how you are doing. As you fill out the following questionnaire try to be completely accurate and honest in your description of any current symptoms you may have. Current symptoms are those you have experienced within the last seven days including today. We would rather you be accurate than miss something significant we should be either dealing with or monitoring on your behalf.
 

If you counselor asked you to complete the SCL-90R or My Currrent Symptoms


Click Here to Begin
GOD IMAGE INVENTORY 

The God Image Inventory is a way to understand how you see God. Sometimes it is referred to as your perception of God as opposed to how you think about God. We might call this the "God of the gut".

If your counselor has asked you to complete the God Image Inventory

Click Here To Begin
ABUSE & NEGLECT 

As a counselor or therapist, it is important to determine the type and extent or level of any abuse or neglect in a person's past. Abuse and neglect can significantly affect an individual's development and maturation. Any abuse and neglect needs to be assessed for potential treatment to determine how it is currently affecting the individual's functioning. Unresolved abuse or neglect, being defined as any abuse or neglect that still produces either negative feelings/emotions or bad memories, especially needs to be identified and resolved.

If your counselor has asked you to complete the Abuse & Neglect Checklist

Click Here To Begin
MEMORY LIST 

In order to better understand you it is often helpful to look back on your life at the positive or pleasurable memories and the negative or painful memories. Would you please complete a memory list starting at your earliest memory and working your way to today? The list should include those significant memories that stand out as you think about your life. Some memories may be both positive and negative or have both pain and pleasure in them. Memories are stored as pictures or images and felt as emotions or feelings. When you see a memory in your minds eye you may also experience an emotion. As you look back on your life please list the memory briefly and any associated emotion or feeling.

 

 

                                   If you counselor asked you to complete the Memory List

 

 
MOOD CHART 

If you counselor asked you to complete the Mood Chart

Click here to begin
STRESS AND USAGE SCALE 

If you counselor asked you to complete the Stress and Usage Scale

Click here to begin
PERSONAL TREATMENT PLAN 

If your conselor asked you to print the Personal Treatment Plan

Click here to begin
SLEEP DIARY 

If your conselor asked you to print the Sleep Diary

Click Here to Begin
Site Mailing List 

Christian Counseling Centers of Indiana
Two Locations:
Avalon Christian Counseling Center - Fort Wayne, Indiana
Auburn Christian Counseling Center - Auburn, Indiana