Parent/Caregiver Check In

Gather helpful updates from parents and caregivers before a child or teen’s therapy session with this simple, professional check-in form.

This worksheet gives caregivers a structured way to share what they have observed at home, including emotional changes, routines, communication, strengths, concerns, important transitions, and strategies that have been helpful.

The form is designed to support collaboration without treating the caregiver’s perspective as the child or teen’s entire experience.

This resource includes:

• One Parent/Caregiver Check-In Form
• US Letter size: 8.5 × 11 inches
• High-quality printable PDF
• Sections for strengths, challenges, home changes, mood, routines, and helpful strategies
• Calm, professional, ink-friendly design

Helpful for:

• Child and adolescent therapists
• Licensed clinical social workers
• Professional counselors
• School counselors
• Play therapists
• Psychologists
• Behavioral health providers

How to use:

Provide the form to a parent or caregiver before a therapy appointment, during a caregiver consultation, or between sessions. Review the information alongside—not in place of—the child or teen’s own perspective.

Please note:

This is a digital product. No physical item will be mailed.

This resource is intended as a supportive clinical tool and is not a diagnostic assessment, treatment protocol, or substitute for professional judgment.

Purchase includes a single-provider license. You may print or reproduce the resource for use with your own clients. You may not resell, share, distribute, alter for resale, or claim the design as your own.

Because this is a digital download, purchases are generally nonreturnable. Please contact UpwellCo if you experience a problem with your file.