Speech Therapy New Client Intake Form

Streamline Your Speech Therapy Practice with a Professional Intake Form

Starting speech therapy services begins with understanding each client's unique communication needs, developmental history, and goals. This Speech Therapy New Client Intake Form is designed specifically for speech-language pathologists (SLPs), speech therapy clinics, and private practices to gather comprehensive information efficiently and professionally before the first session.

Why Speech Therapists Need a Digital Intake Solution

Traditional paper intake forms create administrative bottlenecks that delay care and frustrate families. Parents forget forms at home, handwriting is illegible, and manually entering information into client management systems wastes valuable clinical time. A digital intake form solves these challenges by allowing families to complete detailed information from home before their appointment, giving you clean, organized data that's ready to review.

This template collects everything speech therapists need: communication concerns and goals, developmental milestone history, medical and birth history, previous evaluations and diagnoses, current medications, insurance authorization details, school accommodations (IEPs/504 plans), and family preferences for assessment scheduling. The conditional logic ensures families only see relevant questions based on their child's age and situation, making the experience feel personalized rather than overwhelming.

Designed for Pediatric and Adult Speech Therapy Practices

Whether you specialize in early intervention, school-age language disorders, articulation therapy, fluency treatment, voice disorders, swallowing difficulties, or adult rehabilitation following stroke or injury, this intake form adapts to your practice needs. The form captures developmental milestones for pediatric clients while remaining appropriate for adult clients seeking services for aphasia, dysarthria, voice concerns, or cognitive-communication disorders.

Speech-language pathologists working in private practice, hospital-based outpatient clinics, telepractice settings, school-based services, or multidisciplinary pediatric clinics will find this template immediately useful. The form is also valuable for practices that contract with early intervention programs, accept insurance, or need detailed documentation for evaluation reports and treatment planning.

Capture Critical Clinical Information Before the First Session

The form systematically collects the clinical details that inform your evaluation approach:

• Communication concerns in the family's own words, including speech sound errors, language delays, stuttering, voice quality, social communication challenges, or feeding/swallowing difficulties
• Developmental milestone history covering first words, phrase speech, motor milestones, and social-emotional development
• Medical and birth history including pregnancy complications, NICU stays, chronic ear infections, hearing status, and relevant diagnoses
• Previous evaluations and therapy to understand what's already been tried and what reports you should request
• Current medications and diagnoses that may impact communication or treatment planning
• Educational information including school accommodations, IEP/504 plan status, and current services

This comprehensive information helps you prepare for the evaluation, identify areas requiring deeper assessment, request relevant records in advance, and immediately spot red flags that may require referral to other specialists.

Insurance Verification and Authorization Made Simple

For practices that accept insurance, this form streamlines the verification process by collecting subscriber information, policy numbers, group numbers, and authorization details upfront. You'll know before the appointment whether the family has coverage, needs a referral, or prefers private pay, allowing your administrative team to verify benefits and obtain authorizations without last-minute surprises.

The form can be customized to include fields for specific insurance requirements in your region, authorization numbers, or estimated copay information, helping families understand their financial responsibility before services begin.

Schedule Assessments and Collect Preferences in One Place

Rather than playing phone tag to find appointment times, the intake form includes scheduling preferences where families can indicate their availability, preferred days and times, and any scheduling constraints. For practices offering both in-person and telepractice services, clients can indicate their preference, helping you efficiently book the right type of appointment from the start.

Professional, HIPAA-Compliant Data Collection

Paperform is SOC 2 Type II compliant and provides the security infrastructure needed for healthcare practices collecting protected health information. Forms can be secured with SSL encryption, and submissions are stored safely with access controls, helping your practice maintain compliance with privacy regulations.

The professional, branded design ensures families feel confident in your practice from their very first interaction. You can customize fonts, colors, and add your practice logo to create a cohesive brand experience that builds trust before the first appointment.

Automate Your Intake Workflow with Stepper

Once a family submits their intake form, Stepper (stepper.io) can automatically trigger your onboarding workflow: send a welcome email with next steps, create the client record in your practice management system, add the appointment to your calendar, notify your billing team to verify insurance, and set reminders to request records from previous providers. This automation eliminates manual data entry and ensures nothing falls through the cracks during the busy intake process.

For practices that require consent forms and privacy agreements, Papersign (papersign.com) integrates seamlessly to collect electronic signatures on HIPAA authorization forms, treatment consent documents, financial policies, and telehealth agreements—keeping all client documentation connected and compliant.

Built for Speech-Language Pathologists Who Value Efficiency

This template is optimized for the real-world needs of busy SLPs who want to spend more time providing therapy and less time on administrative tasks. By collecting detailed, organized information before the first session, you can review the case history, prepare assessment materials, and walk into the evaluation room ready to focus entirely on the client and family.

Whether you're a solo practitioner building your private practice, a clinic owner managing multiple therapists, or a hospital-based SLP coordinating with interdisciplinary teams, this intake form helps you deliver a professional, efficient, and family-centered experience from day one.

Get started with this speech therapy intake form template and transform your new client onboarding process today.