TemplatesCounseling Intake Form Template

Send your counseling patients this intake form before the first appointment to collect all the necessary information. To duplicate this template and import it into your Paperform account, simply click the button "Use this template" below.

This counseling intake form is quite comprehensive, and thus we broke it down into two pages (hint: when editing your form, use page breaks to create more form-pages). The first page collects all the basic personal information of the patient, as well as the contact details of the next of kin. The second page asks a number of questions related to the patient's emotional health, allowing them to choose among the multiple-choice options. Please note that the responders can also select the "Other" field if they can't find a suitable answer.

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