Therapy Intake Form Template

A therapy intake form is a structured questionnaire completed by a new client before their first session. It collects personal details, current mental health concerns, relevant history, medications, emergency contacts, and informed consent, giving the therapist the clinical context needed to prepare for a productive first appointment.

Send the form immediately after a new client books their first session, ideally 24 to 48 hours in advance. This window gives clients time to reflect on their answers without feeling rushed, and gives the therapist enough lead time to review responses before the appointment begins.

The form should ask about previous diagnoses, past hospitalizations, prior therapy experiences, and current medications. A symptom checklist covering anxiety, depression, trauma, grief, sleep issues, and self-harm gives the therapist a baseline picture without requiring clients to write lengthy narratives before they feel comfortable.

Include an explicit consent field at the end of the form that states how information will be stored and used. Offering a 'I have questions first' option alongside 'I consent' respects client autonomy and flags cases that need a brief pre-session call, reducing the risk of misunderstandings about confidentiality limits.

A therapy intake form focuses on psychological history, emotional concerns, and therapeutic consent rather than physical symptoms or insurance billing. It uses trauma-informed, non-judgmental language, includes a mental health symptom checklist, and prioritizes confidentiality framing — details that a standard medical intake form does not typically address.