Free Form Templates → Intake Forms → Therapy Intake

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Acceptance and Commitment Therapy (ACT) Consent Form

Acceptance and Commitment Therapy (ACT) Consent Form

A comprehensive consent and intake form for therapists providing Acceptance and Commitment Therapy (ACT), including treatment authorization, values clarification, mindfulness practices, and committed action planning.

 Acceptance and Commitment Therapy (ACT) Intake Form

Acceptance and Commitment Therapy (ACT) Intake Form

Comprehensive ACT therapy intake form with psychological flexibility assessment, values clarification exercises, and committed action planning to help therapists understand client needs and therapeutic goals.

 Addiction Recovery Program Discovery Form

Addiction Recovery Program Discovery Form

A comprehensive intake form for addiction recovery programs to assess client needs, substance use history, treatment preferences, and recovery goals for personalized care planning.

 Addiction Recovery Therapy Intake Form

Addiction Recovery Therapy Intake Form

A comprehensive intake form for addiction recovery counselors to gather essential information about new clients, including substance use history, previous sobriety attempts, support network, and recovery goals.

 Adoption and Foster Care Therapy Intake Form

Adoption and Foster Care Therapy Intake Form

A comprehensive therapy intake form designed for mental health professionals working with adopted children and foster care placements, capturing placement history, attachment patterns, trauma background, and family integration details.

 Agoraphobia Therapy Intake Form

Agoraphobia Therapy Intake Form

A comprehensive intake form designed for mental health professionals to assess clients experiencing agoraphobia, including panic history, feared situations, avoidance patterns, and safety behaviors.

 Amputation Adjustment Therapy Intake Form

Amputation Adjustment Therapy Intake Form

A compassionate intake form for therapists working with individuals adjusting to limb loss, covering amputation details, phantom pain, prosthetic use, and emotional wellbeing.

 Anxiety Disorder Diagnostic Assessment Form

Anxiety Disorder Diagnostic Assessment Form

A comprehensive clinical form for mental health professionals to assess anxiety disorder symptoms, including panic attack frequency, avoidance behaviors, and physical symptom presentation.

 Binge Eating Disorder Therapy Intake Form

Binge Eating Disorder Therapy Intake Form

A comprehensive intake form for therapists and counselors working with clients experiencing binge eating disorder, collecting information about eating patterns, emotional triggers, diet history, and body image concerns.

 Biofeedback Session Emergency Contact Form

Biofeedback Session Emergency Contact Form

A comprehensive biofeedback therapy intake form that collects emergency contacts, stress baseline information, autonomic dysfunction assessment, sensor placement consent, and home practice expectations for new clients.

 Bipolar Disorder Intake Form

Bipolar Disorder Intake Form

Comprehensive intake form for bipolar disorder assessment, capturing mood episode history, medication trials, family psychiatric history, and current symptoms to support effective treatment planning.

 Blast Injury and TBI Therapy Intake Form

Blast Injury and TBI Therapy Intake Form

A comprehensive intake form for mental health professionals treating blast injury and traumatic brain injury (TBI) patients, capturing injury mechanisms, cognitive symptoms, personality changes, and rehabilitation history.

 Blue Star Family Therapy Intake Form

Blue Star Family Therapy Intake Form

A comprehensive intake form designed for military families seeking therapy support for deployment-related stress, communication challenges, reunion transitions, and child impact assessments.

 Borderline Personality Disorder Assessment Form

Borderline Personality Disorder Assessment Form

A comprehensive clinical assessment tool for screening borderline personality disorder symptoms, including emotion dysregulation, relationship patterns, and behavioral indicators.

 Brain Injury Therapy Intake Form

Brain Injury Therapy Intake Form

A comprehensive intake form for therapists working with brain injury patients, capturing injury details, cognitive and personality changes, current symptoms, and rehabilitation history to inform personalized treatment planning.

 Burn Survivor Counseling Intake Form

Burn Survivor Counseling Intake Form

A compassionate intake form for burn survivors seeking mental health support, covering injury details, physical recovery, emotional challenges, and treatment goals.

 Career Counseling & Vocational Therapy Intake Form

Career Counseling & Vocational Therapy Intake Form

A comprehensive intake form for career counselors and vocational therapists to assess client work history, interests, employment barriers, and educational background to develop effective career development plans.

 Child & Adolescent Mental Health Intake Form

Child & Adolescent Mental Health Intake Form

A comprehensive mental health intake form for children and adolescents, collecting developmental history, school performance, family dynamics, and behavioral concerns to support effective treatment planning.

 Child and Adolescent Therapy Intake Form

Child and Adolescent Therapy Intake Form

A comprehensive intake form for child and adolescent mental health services, capturing developmental history, behavioral concerns, school performance, and family dynamics to support effective treatment planning.

 Chosen Family Therapy Intake Form

Chosen Family Therapy Intake Form

A compassionate intake form for therapists working with clients navigating chosen family relationships, biological family rejection, and the complex emotions of building new kinship bonds.

 Chronic Illness Adjustment Therapy Intake Form

Chronic Illness Adjustment Therapy Intake Form

A compassionate intake form for therapists supporting clients navigating chronic illness, capturing diagnosis details, treatment impact, lifestyle adjustments, and support networks to inform personalized care.

 Chronic Nausea & Hyperemesis Mental Health Intake Form

Chronic Nausea & Hyperemesis Mental Health Intake Form

A specialized mental health intake form for patients experiencing chronic nausea and hyperemesis, assessing symptom severity, nutritional status, medical history, and quality of life impact.

 Cognitive Behavioral Therapy Intake Form

Cognitive Behavioral Therapy Intake Form

A comprehensive CBT intake form with depression screening, anxiety assessment, and therapy goals to help mental health professionals understand new clients and establish treatment plans.

 Combat Stress Reaction Therapy Intake Form

Combat Stress Reaction Therapy Intake Form

A specialized intake form for mental health professionals working with military personnel experiencing combat stress reactions. Captures deployment details, critical incidents, acute symptoms, and unit support information.

 Compassion-Focused Therapy Intake Form

Compassion-Focused Therapy Intake Form

A comprehensive intake form for compassion-focused therapy (CFT) that explores self-criticism patterns, shame experiences, early attachment, and self-soothing abilities to create personalized treatment plans.

 Complex Trauma Therapy Intake Form

Complex Trauma Therapy Intake Form

A comprehensive intake form for complex trauma therapy that explores childhood adverse experiences, attachment patterns, poly-victimization, and readiness for therapeutic work.

 Complicated Bereavement Disorder Intake Form

Complicated Bereavement Disorder Intake Form

A compassionate intake form for mental health professionals assessing complicated grief symptoms, including persistent yearning, identity disruption, and meaning-making difficulties following significant loss.

 Compulsive Lying Therapy Intake Form

Compulsive Lying Therapy Intake Form

A specialized therapy intake form for clients struggling with compulsive lying behaviors. Assesses lying patterns, triggers, consequences, underlying needs, and relationship impact to create personalized treatment plans.

 Compulsive Shopping Therapy Intake Form

Compulsive Shopping Therapy Intake Form

A comprehensive intake form for mental health professionals assessing compulsive shopping behaviors, including spending patterns, debt levels, emotional triggers, and relationship impacts.

 Couples Therapy Intake and Scheduling Form

Couples Therapy Intake and Scheduling Form

A comprehensive intake form for couples seeking therapy that captures relationship details, individual backgrounds, insurance information, and session preferences to streamline the counseling process.

 Couples Therapy Intake & Availability Form

Couples Therapy Intake & Availability Form

A comprehensive intake form for couples therapy that collects relationship information, presenting concerns, therapist preferences, and scheduling availability to streamline the matching and booking process.

 Couples Therapy Intake Form

Couples Therapy Intake Form

A comprehensive couples therapy intake form that assesses relationship dynamics, communication patterns, and individual mental health to help therapists understand and support couples seeking counseling.

 Crisis Counseling Intake Form

Crisis Counseling Intake Form

A comprehensive crisis counseling intake form with safety assessment, stressor evaluation, coping resources inventory, and emergency intervention planning for mental health professionals.

 Dance Movement Therapy Emergency Contact Form

Dance Movement Therapy Emergency Contact Form

A comprehensive emergency contact form for dance movement therapy clients that captures mobility range, body image concerns, rhythm sensitivity, movement preferences, and consent for therapeutic movement exploration.

 Degenerative Disease Counseling Intake Form

Degenerative Disease Counseling Intake Form

A compassionate intake form for counselors supporting clients facing degenerative diseases, covering progressive symptoms, advance care planning, caregiver concerns, and emotional well-being.

 Delusional Disorder Therapy Intake Form

Delusional Disorder Therapy Intake Form

A comprehensive mental health intake form for therapists assessing clients presenting with delusional disorder symptoms, capturing belief content, onset timeline, functional impact, and insight level.

 Depersonalization-Derealization Disorder Therapy Intake Form

Depersonalization-Derealization Disorder Therapy Intake Form

A specialized mental health intake form for clients experiencing depersonalization-derealization disorder, capturing dissociative symptoms, triggers, onset patterns, reality testing abilities, and anxiety comorbidity.

 Dialectical Behavior Therapy (DBT) Intake Form

Dialectical Behavior Therapy (DBT) Intake Form

A comprehensive DBT intake assessment form for therapists to evaluate emotional regulation, distress tolerance skills, interpersonal effectiveness, and crisis planning for new clients beginning dialectical behavior therapy.

 Dialysis Patient Mental Health Intake Form

Dialysis Patient Mental Health Intake Form

A comprehensive intake form for mental health professionals providing counseling to dialysis patients, covering kidney failure history, treatment burden, quality of life assessment, and transplant considerations.

 Divorce & Separation Counseling Intake Form

Divorce & Separation Counseling Intake Form

A compassionate intake form for clients seeking divorce or separation counseling, covering relationship history, custody arrangements, financial concerns, and co-parenting dynamics.

 Domestic Violence Survivor Intake Form

Domestic Violence Survivor Intake Form

A compassionate intake form for domestic violence survivors seeking support services, covering safety assessment, abuse history, immediate needs, and legal involvement to provide appropriate care and resources.

 Eating Disorder Therapy Intake Form

Eating Disorder Therapy Intake Form

A compassionate intake form for eating disorder therapy that gathers essential information about food relationship history, body image concerns, medical complications, and nutritional habits to support effective treatment planning.

 Elder Abuse Counseling Intake Form

Elder Abuse Counseling Intake Form

A comprehensive intake form for mental health professionals providing counseling services to older adults who have experienced abuse, capturing critical information about the abuse, safety concerns, and reporting considerations.

 EMDR Therapy Emergency Contact & Client Intake Form

EMDR Therapy Emergency Contact & Client Intake Form

A comprehensive EMDR therapy intake form that collects emergency contacts, trauma history, dissociation screening, safe place visualization details, and bilateral stimulation preferences for trauma-focused therapy sessions.

 Emotionally Focused Therapy (EFT) Couples Intake Form

Emotionally Focused Therapy (EFT) Couples Intake Form

Comprehensive EFT intake form for couples therapy that assesses attachment patterns, identifies negative interaction cycles, and explores bonding moments to inform therapeutic intervention.

 Endometriosis Pain Psychology Intake Form

Endometriosis Pain Psychology Intake Form

Comprehensive psychological intake form for patients experiencing endometriosis-related pain. Assess symptom severity, treatment history, relationship impacts, and pain coping strategies to provide targeted therapeutic support.

 Executive Coaching & Therapy Intake Form

Executive Coaching & Therapy Intake Form

A comprehensive intake form for executive coaching and therapy clients addressing high-performance stress, imposter syndrome, work-life balance, and leadership development.

 Female Veteran Therapy Intake Form

Female Veteran Therapy Intake Form

Specialized mental health intake form for female veterans addressing military sexual trauma, identity challenges, VA navigation, and recognition issues in a safe, supportive environment.

 Financial Stress and Debt Counseling Intake Form

Financial Stress and Debt Counseling Intake Form

A comprehensive intake form for financial counseling and therapy that assesses debt stress, money beliefs, relationship impacts, and anxiety symptoms to create personalized support plans.

 First Responder Trauma Counseling Intake Form

First Responder Trauma Counseling Intake Form

A compassionate intake form designed specifically for first responders seeking trauma counseling and mental health support for critical incident stress, occupational trauma, and PTSD.

 Fitness Therapy for PTSD Intake Form

Fitness Therapy for PTSD Intake Form

A comprehensive intake form for trauma-informed fitness therapy programs that assess PTSD symptoms, trauma triggers, grounding techniques, somatic experiences, and exercise tolerance to create safe, personalized therapeutic movement plans.

 Gastroparesis Mental Health Intake Form

Gastroparesis Mental Health Intake Form

A comprehensive mental health intake form for clients with gastroparesis, addressing nutritional challenges, weight changes, medical interventions, and eating disorder risk assessment.

 Gender Dysphoria Therapy Intake Form

Gender Dysphoria Therapy Intake Form

A comprehensive intake form for therapists working with clients experiencing gender dysphoria, covering gender identity history, transition goals, and support systems.

 Gestalt Therapy Intake Form

Gestalt Therapy Intake Form

A comprehensive intake form for Gestalt therapists to assess new clients' present awareness, emotional patterns, and readiness for authentic therapeutic contact and growth.

 Gottman Method Couples Therapy Intake Form

Gottman Method Couples Therapy Intake Form

A comprehensive intake form for couples therapists using the Gottman Method, assessing relationship satisfaction, conflict patterns, individual goals, and commitment levels to create effective treatment plans.

 Gottman Method Couples Therapy Scheduling & Assessment

Gottman Method Couples Therapy Scheduling & Assessment

Schedule your initial Gottman Method couples therapy session and complete a comprehensive relationship assessment to help your therapist understand your communication patterns, conflict areas, and therapy goals.

 Grief and Loss Coaching Intake Form

Grief and Loss Coaching Intake Form

A compassionate intake form for grief and loss coaching that gathers essential information about your loss, current support system, coping mechanisms, and healing goals to create a personalized coaching journey.

 Grief Counseling Intake Form

Grief Counseling Intake Form

A compassionate intake form for grief counseling that gathers essential information about your loss, current coping strategies, and support network to help provide personalized bereavement support.

 Grief to Growth Coaching Intake Form

Grief to Growth Coaching Intake Form

A compassionate intake form for grief and transformational growth coaching that explores your loss experience, healing journey, and path toward post-traumatic growth and renewed purpose.

 Group Therapy Pre-Screening Intake Form

Group Therapy Pre-Screening Intake Form

A comprehensive intake form for mental health professionals to assess client suitability for group therapy, including confidentiality agreements, personal goals, availability, and group dynamics compatibility.

 Health Anxiety Therapy Intake Form

Health Anxiety Therapy Intake Form

A comprehensive intake form for therapists working with clients experiencing health anxiety. Assess illness fears, reassurance-seeking behaviors, medical appointment frequency, and body-checking patterns.

 Hearing Loss & Cochlear Implant Counseling Intake Form

Hearing Loss & Cochlear Implant Counseling Intake Form

A comprehensive intake form for audiologists, hearing loss counselors, and cochlear implant specialists to gather patient hearing history, communication needs, identity considerations, and assistive technology requirements.

 Horticulture Therapy Program Emergency Contact Form

Horticulture Therapy Program Emergency Contact Form

A comprehensive emergency contact form for horticulture therapy programs that captures participant information, plant allergies, outdoor tolerance levels, gardening experience, and therapeutic goals.

 Hypnotherapy Session Emergency Contact Form

Hypnotherapy Session Emergency Contact Form

A comprehensive intake form for hypnotherapy clients that collects emergency contact details, screens for dissociative disorders, assesses trauma history and suggestibility, and obtains recording consent for safe therapeutic practice.

 Imposter Syndrome Counseling Intake Form

Imposter Syndrome Counseling Intake Form

A specialized intake form for therapists and counselors working with clients experiencing imposter syndrome, capturing achievement history, self-doubt patterns, perfectionism traits, and success attribution styles.

 Infertility Counseling Intake Form

Infertility Counseling Intake Form

A compassionate intake form for individuals and couples seeking counseling support through their infertility journey, covering treatment history, emotional impact, and therapeutic goals.

 Intermittent Explosive Disorder Therapy Intake Form

Intermittent Explosive Disorder Therapy Intake Form

A comprehensive mental health intake form designed for therapists treating clients with intermittent explosive disorder, covering rage episodes, violence history, relationship impacts, and legal consequences.

 Interpersonal Therapy Consent Form for Depression

Interpersonal Therapy Consent Form for Depression

A comprehensive consent and intake form for interpersonal therapy (IPT) focusing on depression treatment, relationship patterns, role transitions, and grief processing.

 Ketamine-Assisted Psychotherapy Screening Form

Ketamine-Assisted Psychotherapy Screening Form

A comprehensive screening form for ketamine-assisted psychotherapy programs, evaluating treatment-resistant depression history, medical clearance requirements, and integration session planning for prospective patients.

 Learning Disability Counseling Intake Form

Learning Disability Counseling Intake Form

A comprehensive intake form for counselors working with clients with learning disabilities. Gather information about academic challenges, diagnosis history, emotional wellbeing, and accommodation needs to provide personalized support.

 Life After Loss Coaching Intake Form

Life After Loss Coaching Intake Form

A compassionate intake form for grief and bereavement coaching that helps coaches understand clients' loss, grief journey, and goals for moving forward with meaning and hope.

 Limb Difference & Congenital Disability Therapy Intake Form

Limb Difference & Congenital Disability Therapy Intake Form

A comprehensive therapy intake form designed for clients with limb differences or congenital disabilities, covering medical history, adaptive equipment needs, social experiences, and self-acceptance.

 Long COVID Mental Health Intake Form

Long COVID Mental Health Intake Form

A compassionate intake form for mental health support addressing the psychological impact of Long COVID, including illness timeline, persistent symptoms, medical gaslighting experiences, and functional limitations.

 Marriage and Couples Therapy Intake Form

Marriage and Couples Therapy Intake Form

A comprehensive intake form for marriage and couples therapists to collect relationship history, conflict areas, communication patterns, and individual mental health backgrounds from new clients.

 Medical Decision-Making Counseling Intake Form

Medical Decision-Making Counseling Intake Form

A comprehensive intake form for counselors and therapists working with clients navigating complex medical decisions, treatment options, and end-of-life planning.

 Medical Detox Admission Form

Medical Detox Admission Form

A comprehensive medical detox intake form for assessing substance dependence severity, withdrawal risks, co-occurring mental health conditions, and medication-assisted treatment eligibility.

 Medical Equipment Dependence Mental Health Intake Form

Medical Equipment Dependence Mental Health Intake Form

A specialized mental health intake form for clients who rely on medical equipment, addressing device dependence, lifestyle impact, body image concerns, and technology-related anxiety.

 Mental Health Intake & Symptom Assessment

Mental Health Intake & Symptom Assessment

A comprehensive mental health intake form with PHQ-9 depression screening, GAD-7 anxiety assessment, and automated crisis intervention routing for safer, more informed care.

 Mental Health Therapist Intake and Scheduling Form

Mental Health Therapist Intake and Scheduling Form

A confidential intake and appointment booking form for mental health therapy practices. Collect client information, assess needs, and schedule in-person or teletherapy sessions securely.

 Midlife Crisis Counseling Intake Form

Midlife Crisis Counseling Intake Form

A comprehensive intake form for counselors and therapists working with clients experiencing midlife transitions, identity questions, and life reassessment.

 Military and Veteran Therapy Intake Form

Military and Veteran Therapy Intake Form

A comprehensive mental health intake form designed specifically for military service members and veterans, capturing service history, combat exposure, PTSD symptoms, and VA benefits information.

 Military Chaplain Moral Injury & Spiritual Crisis Intake Form

Military Chaplain Moral Injury & Spiritual Crisis Intake Form

A compassionate intake form for military chaplains experiencing moral injury, spiritual crisis, compassion fatigue, and faith struggles from bearing witness to trauma in service.

 Military-Connected Caregiver Intake Form

Military-Connected Caregiver Intake Form

A comprehensive intake form for caregivers of military service members and veterans, assessing caregiving demands, service member conditions, VA resources, and caregiver burnout levels.

 Military Spouse and Family Counseling Intake Form

Military Spouse and Family Counseling Intake Form

A comprehensive intake form designed for mental health professionals working with military spouses and families, addressing deployment stress, relocation challenges, parenting concerns, and identity issues unique to military life.

 Miscarriage and Pregnancy Loss Therapy Intake Form

Miscarriage and Pregnancy Loss Therapy Intake Form

A compassionate intake form for mental health professionals supporting clients through miscarriage and pregnancy loss, covering loss history, grief symptoms, support systems, and concerns about future pregnancy.

 Multiple Sclerosis Mental Health Intake Form

Multiple Sclerosis Mental Health Intake Form

A specialized mental health intake form for individuals living with multiple sclerosis, capturing diagnosis timeline, symptom patterns, treatment experiences, and emotional wellbeing to support therapeutic care.

 Music Therapy Client Intake Form

Music Therapy Client Intake Form

A comprehensive intake form for music therapy practices to gather essential client information, therapeutic goals, musical background, sensory preferences, and session planning details.

 Neurodivergent Adult Therapy Intake Form

Neurodivergent Adult Therapy Intake Form

A comprehensive intake form designed for neurodivergent adults seeking therapy, including sections for late diagnosis experiences, masking behaviors, sensory sensitivities, and accommodation needs.

 Neurofeedback Therapy Intake Form

Neurofeedback Therapy Intake Form

Comprehensive intake form for neurofeedback therapy clinics to assess ADHD and anxiety symptoms, schedule brain mapping sessions, and develop personalized training protocols.

 Occupational Therapy Discovery Form

Occupational Therapy Discovery Form

A comprehensive intake and discovery form for occupational therapists to assess daily living challenges, sensory processing concerns, fine motor skills, adaptive equipment needs, and home environment factors.

 Occupational Therapy Emergency Contact Form

Occupational Therapy Emergency Contact Form

A comprehensive form for collecting emergency contact information alongside occupational therapy assessment details, including ADL evaluation, fine motor skills, sensory processing, and daily living challenges.

 OCD Symptom Severity Scale

OCD Symptom Severity Scale

A comprehensive OCD symptom assessment form measuring obsession themes, compulsion frequency, and functional impairment to help healthcare providers understand symptom severity before appointments.

 Organ Failure Mental Health Intake Form

Organ Failure Mental Health Intake Form

A comprehensive mental health intake form for patients facing organ failure, exploring treatment decisions, quality of life considerations, and family support systems.

 Organ Transplant Counseling Intake Form

Organ Transplant Counseling Intake Form

A comprehensive intake form for mental health professionals providing counseling support to patients before or after organ transplantation, covering psychological adjustment, medication adherence, and donor relationships.

 Palliative Care Mental Health Intake Form

Palliative Care Mental Health Intake Form

A compassionate intake form for mental health professionals supporting palliative care patients, covering illness severity, symptom management, existential concerns, and legacy planning.

 Panic Disorder Assessment Form

Panic Disorder Assessment Form

A comprehensive pre-visit assessment form to screen for panic disorder, track panic attack frequency, evaluate physical symptoms, and assess for agoraphobia.

 Paranoia and Psychosis Therapy Intake Form

Paranoia and Psychosis Therapy Intake Form

Comprehensive mental health intake form for clients experiencing paranoia and psychosis, including symptom assessment, medication history, and treatment background.

 Parentification Trauma Therapy Intake Form

Parentification Trauma Therapy Intake Form

A comprehensive intake form for therapists working with clients experiencing parentification trauma, exploring childhood role reversal, emotional burdens, and current relationship patterns.

 Parkinson's Disease Mental Health Intake Form

Parkinson's Disease Mental Health Intake Form

A specialized intake form for mental health professionals supporting individuals with Parkinson's disease, assessing motor symptoms, emotional wellbeing, depression, and caregiver stress levels.

 Pathological Demand Avoidance (PDA) Therapy Intake Form

Pathological Demand Avoidance (PDA) Therapy Intake Form

A comprehensive intake form for therapists working with clients experiencing Pathological Demand Avoidance (PDA), capturing avoidance patterns, anxiety triggers, meltdown frequency, and daily functioning impact.

 Perfectionism and Overachievement Therapy Intake Form

Perfectionism and Overachievement Therapy Intake Form

A specialized therapy intake form designed to assess perfectionism traits, overachievement patterns, fear of failure, productivity guilt, and burnout risk for mental health professionals working with high-achieving clients.

 Performance Anxiety Counseling Intake Form

Performance Anxiety Counseling Intake Form

A comprehensive intake form for mental health professionals working with athletes, musicians, and public speakers experiencing performance anxiety. Captures competition history, anxiety symptoms, and treatment goals.

 Personality Disorder Therapy Intake Form

Personality Disorder Therapy Intake Form

A comprehensive intake form for therapists conducting initial assessments for personality disorder treatment, covering relationship patterns, emotional regulation, identity, and risk factors.

 Physical Therapy Clinic Emergency Contact Form

Physical Therapy Clinic Emergency Contact Form

A comprehensive emergency contact and patient intake form for physical therapy clinics, capturing emergency contacts, referring physician details, injury history, pain baseline, and insurance information.

 Physical Therapy Discovery Questionnaire

Physical Therapy Discovery Questionnaire

A comprehensive physical therapy intake form to assess injuries, pain levels, functional limitations, treatment history, and rehabilitation goals for new patients.

 Physician Burnout Counseling Intake Form

Physician Burnout Counseling Intake Form

A comprehensive intake form for physicians seeking counseling support for burnout, stress, and career-related challenges. Captures specialty, work hours, moral distress, malpractice concerns, and career satisfaction.

 Play Therapy Intake Form

Play Therapy Intake Form

A comprehensive intake form for play therapy services designed to gather essential information about the child, parent concerns, developmental history, and family dynamics to create an effective treatment plan.

 Play Therapy Intake Scheduling Form

Play Therapy Intake Scheduling Form

Schedule your child's initial play therapy consultation with comprehensive intake questions covering behavioral concerns, developmental history, and parent participation preferences.

 Polyamory Counseling Intake Form

Polyamory Counseling Intake Form

A comprehensive intake form for polyamorous clients seeking relationship counseling, covering relationship structures, communication patterns, jealousy management, and boundary-setting needs.

 Postural Restoration Therapy Intake Form

Postural Restoration Therapy Intake Form

A comprehensive intake form for virtual postural restoration therapy sessions, designed to assess posture asymmetries, breathing patterns, and performance goals to create a personalized treatment plan.

 Prolonged Exposure Therapy Intake Form for PTSD

Prolonged Exposure Therapy Intake Form for PTSD

Comprehensive intake form for prolonged exposure therapy (PE) to assess PTSD symptoms, develop trauma narratives, create in vivo exposure hierarchies, and evaluate distress tolerance for evidence-based trauma treatment.

 Psychedelic Integration Therapy Intake Form

Psychedelic Integration Therapy Intake Form

A comprehensive intake form for mental health professionals providing psychedelic integration therapy to help clients process their experiences, capture insights, and establish therapeutic goals.

 Psychiatry Medication Management Intake Form

Psychiatry Medication Management Intake Form

A comprehensive psychiatric medication management intake form for new patients to document current medications, side effects, substance use history, and treatment preferences.

 Psychogenic Non-Epileptic Seizures (PNES) Therapy Intake Form

Psychogenic Non-Epileptic Seizures (PNES) Therapy Intake Form

Comprehensive intake form for mental health professionals specializing in PNES treatment, collecting seizure history, medical testing results, trauma background, and neurological consultation information.

 Psychosis Early Intervention Assessment Form

Psychosis Early Intervention Assessment Form

A comprehensive first-episode psychosis screening and coordinated specialty care enrollment form for mental health services, including clinical assessment, family education needs, and treatment planning.

 PTSD and Trauma Therapy Intake Form

PTSD and Trauma Therapy Intake Form

A comprehensive intake form for trauma and PTSD therapy clients, including trauma history, symptom assessment, safety evaluation, and crisis contact information.

 PTSD Symptom Checklist & Assessment Form

PTSD Symptom Checklist & Assessment Form

A comprehensive pre-visit assessment form for evaluating PTSD symptoms, trauma exposure history, flashback frequency, and avoidance behaviors to help healthcare providers prepare for patient consultations.

 Religious Trauma Therapy Intake Form

Religious Trauma Therapy Intake Form

A compassionate intake form for therapists working with clients experiencing religious trauma, covering faith background, harmful teachings, deconstruction journey, and current spiritual identity.

 Reproductive Mental Health Intake Form

Reproductive Mental Health Intake Form

A comprehensive intake form for reproductive mental health counseling, covering fertility treatment stress, pregnancy loss history, and hormonal mood changes.

 Reproductive Trauma Therapy Intake Form

Reproductive Trauma Therapy Intake Form

A comprehensive, compassionate intake form for therapists supporting clients through fertility struggles, pregnancy loss, birth trauma, and reproductive medical experiences.

 Schema Therapy Scheduling & Assessment Form

Schema Therapy Scheduling & Assessment Form

A professional intake and scheduling form for schema therapy practitioners to identify early maladaptive schemas, assess mode work interest, evaluate limited reparenting openness, and verify insurance coverage before the first session.

 Schema Therapy Visitor Intake Form

Schema Therapy Visitor Intake Form

A comprehensive intake form for schema therapy practices to gather client information, identify early maladaptive schemas, assess mode patterns, and establish a foundation for therapeutic work using limited reparenting and core emotional needs frameworks.

 Schizophrenia Spectrum Evaluation Form

Schizophrenia Spectrum Evaluation Form

A comprehensive psychiatric evaluation form for assessing schizophrenia spectrum disorders, including psychotic symptom checklists, medication history, and hospitalization records for mental health professionals.

 Seasonal Depression Coaching Intake Form

Seasonal Depression Coaching Intake Form

A compassionate coaching intake form for clients experiencing seasonal affective disorder (SAD), gathering information about symptom history, severity, current coping strategies, and mood management goals to create personalized support plans.

 Selective Mutism Therapy Intake Form

Selective Mutism Therapy Intake Form

A comprehensive intake form for children and adolescents with selective mutism, capturing communication patterns across different settings, anxiety triggers, and social participation to guide personalized treatment planning.

 Sexual Dysfunction Therapy Intake Form

Sexual Dysfunction Therapy Intake Form

A comprehensive intake form for sexual dysfunction therapy that assesses relationship satisfaction, medical factors, performance anxiety, and intimacy goals to help therapists provide personalized treatment.

 Social Isolation & Loneliness Counseling Intake Form

Social Isolation & Loneliness Counseling Intake Form

A comprehensive intake form for therapists working with clients experiencing social isolation and loneliness, covering relationship history, withdrawal patterns, technology use, and barriers to connection.

 Somatic Experiencing Therapy Program Information Request

Somatic Experiencing Therapy Program Information Request

Request detailed information about our somatic experiencing therapy program, share your background, and schedule an initial intake consultation to begin your healing journey.

 Special Operations Mental Health Intake Form

Special Operations Mental Health Intake Form

A comprehensive mental health intake form designed for special operations veterans transitioning to civilian life, addressing classified trauma, hyper-vigilance, identity concerns, and operational stress.

 Speech Therapy New Client Intake Form

Speech Therapy New Client Intake Form

Comprehensive intake form for speech-language pathology practices to gather client communication concerns, developmental history, medical background, and insurance information for new patient onboarding.

 Sports Psychology Consultant Intake Form

Sports Psychology Consultant Intake Form

A comprehensive intake form for sports psychology consultants to gather essential information about new clients, including their sport, competitive level, performance concerns, mental blocks, and consultation preferences.

 Stroke Rehabilitation Counseling Intake Form

Stroke Rehabilitation Counseling Intake Form

A comprehensive intake form for stroke survivors beginning counseling to support emotional recovery, cognitive changes, and family adjustment during rehabilitation.

 Substance Abuse Counseling Intake Form

Substance Abuse Counseling Intake Form

A comprehensive intake form for substance abuse counseling that captures usage history, triggers, previous treatment attempts, and family addiction patterns to support effective treatment planning.

 Telehealth Eating Disorder Assessment Form

Telehealth Eating Disorder Assessment Form

A comprehensive virtual assessment form for eating disorder treatment that tracks meal plan adherence, evaluates body image concerns, monitors exercise patterns, and obtains family-based treatment consent.

 Telepsychiatry Evaluation Form

Telepsychiatry Evaluation Form

A comprehensive telepsychiatry intake and assessment form for virtual mental health evaluations, including mental status assessment, medication management consent, crisis planning, and pharmacy information.

 Terminal Illness Counseling Intake Form

Terminal Illness Counseling Intake Form

A compassionate intake form for mental health professionals supporting clients facing terminal illness, covering diagnosis details, treatment preferences, emotional support needs, legacy planning, and end-of-life considerations.

 Therapist First Session Scheduling & Intake Form

Therapist First Session Scheduling & Intake Form

Schedule your first therapy session, provide insurance details, and complete an initial intake questionnaire so your therapist can prepare for your visit.

 Trauma-Focused CBT Consent & Intake Form for Children

Trauma-Focused CBT Consent & Intake Form for Children

A comprehensive consent form for trauma-focused cognitive behavioral therapy (TF-CBT) services for children with trauma history, including caregiver authorization, treatment goals, and baseline symptom tracking.

 Trauma-Focused Therapy Intake Form

Trauma-Focused Therapy Intake Form

A comprehensive intake form for trauma-focused therapy that includes PTSD screening, trigger identification, and collaborative safety planning to support healing and recovery.

 Traumatic Injury & Sudden Disability Intake Form

Traumatic Injury & Sudden Disability Intake Form

A comprehensive mental health intake form for individuals adjusting to sudden disability following traumatic injury, exploring life transitions, loss of independence, changing family roles, and meaning-making.

 Trichotillomania Therapy Intake Form for Children

Trichotillomania Therapy Intake Form for Children

A comprehensive intake form designed for mental health professionals working with children experiencing trichotillomania (hair-pulling disorder), capturing detailed information about pulling patterns, triggers, parental responses, and school impact.

 Veteran Reintegration Counseling Intake Form

Veteran Reintegration Counseling Intake Form

A comprehensive intake form for mental health professionals working with veterans transitioning to civilian life, covering deployment history, adjustment challenges, relationships, and purpose discovery.

 Virtual Pelvic Floor Therapy Intake Form

Virtual Pelvic Floor Therapy Intake Form

A comprehensive intake form for virtual pelvic floor therapy sessions, capturing symptom severity, treatment history, and establishing care protocols for remote physiotherapy consultations.

 Wilderness Therapy & Adventure Fitness Intake Form

Wilderness Therapy & Adventure Fitness Intake Form

Comprehensive intake form for wilderness therapy and adventure fitness programs, assessing outdoor experience, mental health needs, physical readiness, and personal transformation goals.

 Workplace Mobbing Counseling Intake Form

Workplace Mobbing Counseling Intake Form

A comprehensive intake form for therapists and counselors working with clients experiencing workplace mobbing, bullying, or group harassment. Captures psychological impact, documentation, employment status, and group dynamics.

 Workplace Stress & Burnout Therapy Intake Form

Workplace Stress & Burnout Therapy Intake Form

A comprehensive intake form for therapists and counselors working with clients experiencing workplace stress, burnout, and career-related mental health concerns.

Streamline Your Mental Health Practice with Therapy Intake Forms

Therapy intake forms are essential tools for mental health professionals, counselors, and therapists to gather comprehensive client information before the first session. These forms help you understand your clients' backgrounds, mental health history, treatment goals, and any immediate concerns, enabling you to provide more effective and personalized care from day one.

Who Are These Templates For?

Our therapy intake form templates are designed for psychologists, licensed therapists, counselors, social workers, psychiatrists, and mental health clinics. Whether you run a private practice or work within a larger healthcare organization, these templates help you collect vital information efficiently and professionally.

Why Choose Paperform for Therapy Intake?

Paperform's therapy intake templates make client onboarding seamless and secure. Collect detailed mental health histories, current symptoms, medication lists, and emergency contact information through forms that are both comprehensive and easy to complete. With conditional logic, you can show relevant questions based on client responses, creating a personalized intake experience.

Secure eSignatures through Papersign allow clients to consent to treatment digitally, while integrated payment collection lets you process session fees or retainers upfront. Our forms are mobile-friendly, so clients can complete their intake paperwork from any device before their appointment. You can also integrate with your practice management software to automatically sync client data, reducing administrative work and allowing you to focus on what matters most—providing exceptional care.