View worksheetCBT assessment worksheet
Prepare for a first CBT appointment or make notes with a therapist. Includes a recent example, patterns, health, support and goals.
4 pages · A4 · Fillable PDF · 863 KB
Read the guidance
Use the first three pages to note what you would like help with, one recent difficult moment, wider patterns, health, support and goals. The final page is a concise prompt sheet for a therapist to use during an appointment.
How to use it
- Choose the fillable PDF to type in a PDF reader, or print the blank version. Brief notes are enough; use another sheet if needed.
- Leave anything you would rather discuss in person. You do not need to complete the form before asking for support.
- Keep the completed copy private and agree any sharing with your therapist. Typing in the PDF does not submit information to this website.
The form supports an assessment conversation. It is not a diagnostic questionnaire, a complete clinical assessment or a safety score. If you need urgent help, contact appropriate urgent or emergency services rather than wait for the form to be read.
Guidance: NHS: cognitive behavioural therapy; NICE: shared decision making; NICE: self-harm assessment and care.
















































































