An Intake Form — Adult and Therapist is a document that is used by mental health professionals to collect initial information about a patient's health history, current concerns, and goals for therapy. The Intake Form typically consists of questions about the patient's personal information such as name, address, contact information, and date of birth. It also includes questions about the patient's medical history, present physical and mental health, and any current medications. The form is usually completed by the patient in collaboration with the therapist during their first session. There are three different types of Intake Form — Adult and Therapist: 1. General Intake Form: The General Intake Form is the most common type and is used to collect basic information about the patient's physical and mental health. It may include questions about the patient's family history, lifestyle, and educational background. 2. Diagnostic Intake Form: The Diagnostic Intake Form is used to collect more detailed information about the patient's mental health. It typically includes questions about past mental health issues, current mental health symptoms, and any psychiatric diagnoses the patient has been given. 3. Treatment Intake Form: The Treatment Intake Form is used to collect information about the patient's goals for therapy and their expectations of the therapists. It usually includes questions about the patient's desired outcomes, treatment preferences, and any relevant cultural factors.
Intake Form - Adult and Therapist
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FAQ
A counseling intake form is a document a client completes before their first session with a therapist or counselor. The form typically includes personal information, such as the client's contact details, medical history, and current concerns and reasons for seeking therapy.
Basic client information (name, address, phone number, etc.): all types of intake forms should at least include this information. Questions about the problem they're dealing with: can be a personal problem or a business problem. Questions about personal preferences: can help you tailor the service to each client.
The therapist or counselor is free to design their own for use with their clients, but typically the client intake form will include the following details: Patient name. Medical ID. Date of birth. Current age. Phone number/email. Address. Emergency contact. Insurance information.
The questionnaire may include questions about your medical and mental health history and your family history. Try to be as open and honest as possible, as this will help your therapist tailor your treatment in a way that's most beneficial for you.
What is a client intake form? Client intake forms are preliminary paperwork potential customers fill out to determine their fit for your services. These forms ask for information about the person or their business. If their answers line up with the services you provide, you can begin onboarding.
TherapyNotes also includes pre-made Patient Information and Patient Contacts forms, fully-integrated online intake forms that correspond to the Patient Info tab of a client's chart. If you need a signature from your client, there's no need to print out documents for your client to sign in the office.