Medical Decision-Making Counseling Intake Form

Medical Decision-Making Counseling Made Clear

When facing serious medical decisions, many patients and families benefit from professional counseling support to explore treatment options, clarify personal values, and plan for future care scenarios. This Medical Decision-Making Counseling Intake Form helps mental health professionals, social workers, and patient advocates gather the essential information needed to support clients through these difficult conversations.

Designed for healthcare counselors and patient advocates

Whether you're a therapist specializing in medical trauma, a hospital social worker, a palliative care counselor, or a private practitioner supporting clients through health crises, this template streamlines your intake process. It covers medical history context, current decision-making needs, family dynamics, values assessment, and end-of-life preferences in one thoughtful, organized form.

Capture what matters most

This form goes beyond basic contact details to explore:

• Current medical situation and decision points clients are facing
• Treatment options being considered and concerns about each path
• Personal values and priorities that should guide medical choices
• Family involvement and dynamics affecting the decision-making process
• Advance care planning and end-of-life preference discussions
• Cultural, spiritual and religious considerations that influence care choices
• Mental health support needs around anxiety, grief, or decision paralysis

Sensitive, secure and compliant

Built on Paperform's SOC 2 Type II compliant platform, your client intake data is encrypted and stored securely. While Paperform is not HIPAA compliant, it provides professional-grade security suitable for counseling intake and administrative purposes. You can customize the form to match your practice's tone, add your branding, and embed it directly on your website.

Automate your intake workflow with Stepper

Once a client submits their intake form, you can use Stepper to automatically create client records in your practice management system, send welcome packets, schedule initial consultations, and notify relevant team members—all without manual data entry. This gives you more time to focus on providing compassionate, values-aligned counseling support.

Paperform makes it simple to create professional intake experiences that help you understand each client's unique medical decision-making journey before your first session together.