A well-designed therapy intake form is essential for gathering the information you need to provide effective treatment while establishing a professional therapeutic relationship. This guide provides free, HIPAA-aware intake form templates along with best practices for mental health documentation.
Whether you're starting a private practice, updating your existing forms, or transitioning to digital intake, our templates cover all the essential elements required for compliant and comprehensive client onboarding.
In This Guide
Essential Therapy Intake Forms
A complete therapy intake packet typically includes several types of forms. Each serves a specific purpose in gathering necessary information and establishing the therapeutic relationship legally and ethically.
Administrative Forms
- Client demographic information
- Emergency contact form
- Insurance verification
- Payment agreement
- Cancellation policy acknowledgment
Legal/Consent Forms
- Informed consent for treatment
- HIPAA Notice of Privacy Practices
- Authorization for release of information
- Telehealth consent (if applicable)
- Minor consent/parental authorization
Clinical History Forms
- Presenting problem questionnaire
- Mental health treatment history
- Medical history and medications
- Family history
- Substance use history
Assessment Tools
- Depression screening (PHQ-9)
- Anxiety screening (GAD-7)
- Safety assessment/risk screening
- Goals and expectations worksheet
- Quality of life measures
Complete Intake Packet Checklist
Before First Session:
- □ Client information form
- □ Informed consent for treatment
- □ HIPAA Notice of Privacy Practices
- □ Payment/insurance information
- □ Practice policies acknowledgment
During/After First Session:
- □ Mental health history
- □ Standardized assessments
- □ Safety planning (if indicated)
- □ Treatment goals worksheet
- □ Any specialty-specific forms
Client Information Form Template
The client information form collects essential demographic and contact details. This form should be straightforward and inclusive of all family structures and identities.
Client Information Form Template
Personal Information
Contact Information
Emergency Contact
Referral Information
Consent and Authorization Forms
Consent forms establish the legal and ethical foundation of the therapeutic relationship. These must be reviewed and updated regularly to reflect current laws and best practices.
Informed Consent Elements
Required Components of Informed Consent
About the Therapist
- • Professional credentials and license
- • Education and training background
- • Theoretical orientation/approach
- • Areas of specialization
- • Supervision status (if applicable)
About Treatment
- • Nature and purpose of therapy
- • Expected benefits and risks
- • Alternative treatment options
- • Right to refuse or discontinue
- • Session frequency and duration
Confidentiality
- • General confidentiality protections
- • Limits to confidentiality
- • Mandated reporting requirements
- • Record keeping practices
- • Use of information for training/research
Practice Policies
- • Fees and payment expectations
- • Cancellation and no-show policy
- • After-hours contact procedures
- • Emergency procedures
- • Social media and communication
Limits to Confidentiality Disclosure
Must Clearly Disclose When Confidentiality May Be Broken:
- Imminent danger to self: If client expresses intent to harm themselves and has plan/means
- Imminent danger to others: Duty to warn/protect potential victims (Tarasoff)
- Child abuse or neglect: Mandated reporter obligations vary by state
- Elder/dependent adult abuse: Mandated reporting requirements
- Court orders: When compelled by valid court order
- Insurance/billing: Necessary information shared for reimbursement
HIPAA Authorization Form
HIPAA Authorization Template Elements
- □ Description of information to be disclosed
- □ Identification of persons authorized to disclose
- □ Identification of persons authorized to receive
- □ Purpose of the disclosure
- □ Expiration date or event
- □ Right to revoke authorization
- □ Signature and date
- □ Statement about re-disclosure protections
Mental Health History Forms
Comprehensive history forms help you understand the client's background, previous treatment experiences, and current functioning. Organize these into clear sections for ease of completion and review.
Presenting Problem Questionnaire
What brings you to therapy at this time?
When did these concerns begin? Were there any triggering events?
How are these issues affecting your daily life, relationships, and work?
What would you like to accomplish in therapy? What does success look like?
Treatment History Section
Previous Mental Health Treatment
| Provider/Facility | Type of Treatment | Dates | Helpful? |
|---|---|---|---|
| ______________ | □ Therapy □ Inpatient □ Intensive Outpatient | ______ to ______ | □ Yes □ Somewhat □ No |
Current Medications:
Safety Assessment Section
Risk Screening Questions
Note: Positive responses require follow-up safety assessment during intake session.
Assessment and Screening Tools
Standardized screening tools provide objective baseline measurements and help track progress throughout treatment. Many are free to use in clinical practice.
PHQ-9 (Depression)
9-item questionnaire screening for depression severity. Public domain, widely validated.
GAD-7 (Anxiety)
7-item questionnaire measuring generalized anxiety severity. Public domain, quick to administer.
PCL-5 (PTSD)
20-item checklist corresponding to DSM-5 PTSD criteria. Used for screening and monitoring.
AUDIT-C (Alcohol Use)
3-item alcohol screening tool. Quick way to identify unhealthy alcohol use patterns.
Using Standardized Measures Effectively
- Baseline: Administer at intake to establish starting severity
- Progress monitoring: Repeat every 4-8 sessions or as clinically indicated
- Documentation: Include scores in progress notes with interpretation
- Treatment planning: Use severity levels to guide treatment intensity
- Outcome tracking: Compare intake vs. discharge scores for outcomes data
Digital Intake Options
Digital intake forms improve efficiency, reduce errors, and provide a better client experience. Many practice management systems include built-in intake functionality.
Practice Management Systems
- SimplePractice
- TherapyNotes
- Jane App
- TheraNest
- IntakeQ
Built-in HIPAA compliance
Benefits of Digital Intake
- Pre-session completion
- Automatic scoring
- EHR integration
- Secure storage
- Easy updates
Client Experience
- Complete at home
- Save and continue later
- Mobile-friendly
- Autofill capabilities
- Less paper waste
HIPAA Requirements for Digital Forms
- • Use HIPAA-compliant platforms with BAA (Business Associate Agreement)
- • Ensure encryption in transit and at rest
- • Implement access controls and audit logging
- • Do NOT use standard Google Forms, SurveyMonkey, or Typeform
- • Regular security assessments and staff training required
Frequently Asked Questions
What should be included in a therapy intake form?
A comprehensive therapy intake form should include: client demographics and contact information, emergency contact details, presenting problems and therapy goals, mental health history (past treatment, hospitalizations, medications), medical history, family history, substance use history, current medications, insurance information, informed consent for treatment, confidentiality agreements, and HIPAA authorization.
Are therapy intake forms HIPAA compliant?
Therapy intake forms must be stored and transmitted in HIPAA-compliant ways. Paper forms should be kept in locked cabinets; digital forms require encrypted storage and secure transmission. You need a signed HIPAA authorization form allowing you to collect and store PHI. Consider using HIPAA-compliant practice management software for digital intake.
How long should a therapy intake form be?
Most therapy intake packets are 8-15 pages total, including all required forms. The main intake questionnaire is typically 4-6 pages. Too short may miss important information; too long can overwhelm clients. Consider using digital forms that adapt based on responses to keep the experience efficient while gathering necessary data.
Should clients complete intake forms before the first session?
Yes, having clients complete intake forms before the first session is best practice. It allows you to review their history beforehand, maximizes session time for therapeutic work, gives clients time to thoughtfully complete forms, and helps identify any urgent concerns. Send forms 3-7 days before the appointment with clear instructions.
What screening tools should be included in therapy intake?
Common screening tools for therapy intake include: PHQ-9 (depression), GAD-7 (anxiety), PCL-5 (PTSD), AUDIT-C (alcohol use), Drug Abuse Screening Test (DAST-10), Columbia Suicide Severity Rating Scale (C-SSRS), and specialty-specific measures. Choose tools relevant to your practice population and presenting concerns.
Can I use free therapy intake form templates?
Yes, free therapy intake form templates are available and legal to use. However, ensure templates meet your state licensing requirements, are appropriate for your specialty, include all necessary legal disclosures, are updated for current regulations, and are reviewed by legal counsel or your professional association for compliance.
Related Resources
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