心理咨询记录表咨询师：第次咨询姓名性别出生年月学历职业家庭住址既往病史联系方式咨询时间年月日时来访者主诉：________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________咨询要点记录：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________本次咨询作业与下次咨询计划：____________________________________________________________________________________________________________________________咨询师签名：年月日心理咨询记录表咨询师：第次咨询咨询记录：____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________