Telehealth Mental Health Intake Form

Streamline Your Telehealth Mental Health Practice with This Comprehensive Intake Form

As telehealth becomes a cornerstone of modern mental health care, ensuring a smooth and professional onboarding experience is essential. This Telehealth Mental Health Intake Form is designed specifically for therapists, counselors, psychologists, and mental health practitioners who provide remote care to clients.

This template captures everything you need for a compliant, effective telehealth intake process—from patient demographics and presenting concerns to technology readiness, emergency protocols, and state licensure acknowledgments. By gathering all this information upfront, you can focus on what matters most: providing quality care.

What Makes This Template Essential for Telehealth Providers

Unlike traditional in-office intake forms, telehealth requires unique considerations. This form addresses:

• Technology access verification to ensure clients have the necessary devices, internet connection, and software to participate effectively
• Private space confirmation to protect confidentiality during virtual sessions
• Emergency contact protocols tailored for remote care, including backup phone numbers and local emergency services awareness
• State licensure acknowledgments to maintain compliance with jurisdictional requirements
• Informed consent for telehealth covering platform security, recording policies, and session interruption procedures

Perfect for Mental Health Professionals Across Settings

Whether you're a solo practitioner, part of a group practice, or working within a community mental health organization, this form adapts to your needs. It's ideal for:

• Licensed therapists (LMFT, LCSW, LPC) transitioning to or expanding telehealth services
• Psychologists offering virtual assessments and therapy
• Counseling centers and mental health clinics with hybrid care models
• Employee assistance programs (EAPs) providing remote support
• Substance abuse counselors and addiction specialists

Automate Your Intake Workflow with Stepper

Once a client submits this form, you can use Stepper to automate what happens next. Create workflows that automatically add new clients to your practice management system, send welcome packets, schedule initial appointments, and trigger reminder emails—all without manual data entry. Stepper keeps your intake process organized and helps you maintain better records from day one.

Built on Paperform: Secure, Compliant, and Client-Friendly

This template is powered by Paperform, designed with mental health professionals in mind. With SOC 2 Type II compliance and GDPR readiness, your client data stays secure. The form is mobile-friendly, accessible, and can be customized to match your practice's branding. Conditional logic ensures clients only see questions relevant to their situation, making the intake experience smoother and less overwhelming.

Start using this Telehealth Mental Health Intake Form today and provide your clients with a professional, compassionate, and compliant onboarding experience from their very first interaction.