---
title: Military-Connected Caregiver Intake Form Template - Mental Health & Counseling | Paperform
description: Comprehensive intake form for military caregivers assessing service member conditions, caregiving demands, VA resources, and burnout. Built for therapists, counselors, and veteran service providers.
url: "https://paperform.co/templates/military-connected-caregiver-intake-form"
type: static
generatedAt: "2026-03-28T00:44:32.147Z"
---

[← Back to free form templates](/templates/)    ![Military-Connected Caregiver Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/military-connected-caregiver-intake-form.png)
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### Supporting Those Who Support Our Heroes: Military-Connected Caregiver Intake

Caring for a military service member or veteran is both an honor and a profound responsibility. If you're a caregiver navigating the unique challenges of supporting someone who has served, you're not alone—and you deserve comprehensive support that recognizes the complexity of your role.

This **Military-Connected Caregiver Intake Form** template is designed specifically for mental health professionals, counseling centers, VA-affiliated programs, and nonprofit organizations that serve military families. It provides a structured yet compassionate way to understand the full scope of a caregiver's situation, from the service member's condition and care demands to the caregiver's own wellbeing and access to critical resources.

#### Why This Template Matters for Military Caregiver Support

Military-connected caregivers face distinct challenges that civilian caregiving frameworks often don't address. They may be supporting service members with combat-related PTSD, traumatic brain injuries, physical disabilities from deployment, or complex combinations of visible and invisible wounds. The caregiving demands can be constant and emotionally taxing, while navigating VA systems, benefits, and resources adds another layer of complexity.

This intake form helps providers:

 - **Assess the complete picture** of both the service member's condition and the caregiver's responsibilities
 - **Identify burnout risk factors** early, before compassion fatigue becomes a crisis
 - **Connect caregivers to VA resources** they may not know exist, including respite care and support programs
 - **Tailor therapeutic interventions** to the unique stressors military caregivers face
 - **Build trust quickly** by demonstrating understanding of military culture and systems

#### What Makes This Template Effective

The form thoughtfully balances clinical assessment with practical resource planning. It collects essential information about the service member's branch, era of service, and current conditions while also diving deep into the day-to-day realities of caregiving—medication management, appointment coordination, behavioral support, and physical care needs.

Crucially, the template includes validated burnout screening questions and asks about the caregiver's own physical and mental health. Many military caregivers put themselves last, so these questions send an important message: *your wellbeing matters too*.

The form also captures current VA resource utilization, support network strength, and specific areas where the caregiver needs help—creating a clear roadmap for intervention from the very first session.

#### Perfect for Mental Health and Veteran Service Providers

This template is ideal for:

 - **Mental health therapists and counselors** specializing in military families
 - **VA medical centers and community-based outpatient clinics** offering caregiver support programs
 - **Nonprofit organizations** like the Elizabeth Dole Foundation affiliates, Wounded Warrior Project, and military family support networks
 - **Social workers and case managers** coordinating care for military families
 - **Employee assistance programs** serving active-duty families and veterans
 - **Telehealth providers** expanding access to caregiver mental health services

#### Enhancing Your Workflow with Paperform and Automation

Built on **Paperform**, this template does more than collect information—it can transform how you deliver care to military families. The intuitive interface ensures caregivers can complete the form with dignity and ease, whether they're filling it out on their phone between appointments or at home after a long day.

With Paperform's conditional logic, you can show additional questions based on specific responses—for example, if a caregiver indicates high burnout, you might immediately present emergency resources or prioritize their intake for urgent scheduling.

**Papersign integration** ([papersign.com](https://papersign.com)) allows you to seamlessly transition from intake to consent forms, HIPAA authorizations, or VA program agreements, keeping all documentation connected to the original submission for a complete client record.

**Stepper workflows** ([stepper.io](https://stepper.io)) can automate your post-submission processes: route high-risk caregivers to immediate follow-up, create client files in your EHR or practice management system, send welcome packets with VA resource links, schedule initial consultations automatically, and alert your team when urgent intervention may be needed.

This means less administrative burden and more time actually supporting the caregivers who need you.

#### Designed with Military Families in Mind

The language throughout this template has been carefully crafted to be respectful of military culture while remaining accessible and trauma-informed. It acknowledges the courage it takes to ask for help and validates the caregiver's experience without assuming prior knowledge of clinical or VA terminology.

Questions are organized logically to minimize cognitive load—important when your respondents may be completing forms while exhausted from caregiving duties. The form flows naturally from service member background to caregiving tasks to the caregiver's own needs, creating a narrative that providers can use immediately in treatment planning.

#### Compliance and Trust

When working with military families, trust is everything. Paperform is **SOC 2 Type II compliant and GDPR-ready**, with robust security measures that protect sensitive military and health information. You can confidently collect protected health information while meeting regulatory requirements and maintaining the confidentiality military families deserve.

*Please note: While Paperform provides enterprise-grade security, it is not currently HIPAA compliant. Providers requiring HIPAA compliance should consult their compliance team about additional safeguards.*

#### Getting Started

This template is immediately ready to use but fully customizable to match your organization's specific protocols, branding, and therapeutic approach. You can add your logo, adjust the color scheme to be calming and professional, include additional screening tools, or connect to your existing practice management systems.

Whether you're a solo practitioner expanding into military family therapy or a large veteran service organization streamlining intake across multiple locations, this template provides the foundation for more effective, compassionate care.

Military caregivers give everything to support those who served. This intake form ensures they receive the comprehensive, dignified support they deserve in return.
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