Form templates for therapists & mental health
Forms for therapists, counsellors, speech-language pathologists and mental health teams: intake questionnaires, telehealth consent, referrals, group screening and research paperwork you can copy and adapt in an afternoon.
105 use cases29 templates11 categories
An intake form is usually the first thing a new client meets. The wording carries weight — an adolescent answering for themselves needs different questions from a parent describing a seven-year-old, and a trauma history section should only open when the client says it applies.
Conditional logic handles that. Encryption covers submissions at rest and in transit, EU hosting is available, and the sensitive sections can sit on an end-to-end encrypted form that only you can decrypt. What you will not find is HIPAA compliance or a scoring engine — the form gathers answers; the clinical judgement stays with you.
96 forms therapists & mental health actually build
Each one starts from a template you can open and edit. Grouped by the kind of form it is.
Healthcare form templates
- Pediatric Articulation Disorder IntakeCollects developmental speech milestones, phonological patterns observed by parents, and previous evaluations for children with speech sound disorders.Start fromSpeech Therapy Intake Form
- Adult Aphasia Rehabilitation IntakeGathers stroke or brain injury history, current functional communication abilities, and prior speech therapy for adults with aphasia.Start fromSpeech Therapy Intake Form
- Stuttering Evaluation Intake FormAsks about fluency history, severity in different speaking situations, emotional impact, and prior fluency therapy experience.Start fromSpeech Therapy Intake Form
- Voice Disorder Evaluation IntakeCollects vocal use patterns, occupation, smoking history, reflux symptoms, and prior ENT consultations for patients with voice concerns.Start fromSpeech Therapy Intake Form
- Pediatric Language Delay IntakeCaptures developmental milestones, expressive and receptive language concerns, and bilingual status for children with suspected language delays.Start fromSpeech Therapy Intake Form
- Dysphagia Swallowing Evaluation IntakeGathers medical diagnoses, diet texture current tolerance, mealtime observations, and aspiration history for patients with swallowing difficulties.Start fromSpeech Therapy Intake Form
- Autism Spectrum Communication IntakeCollects current AAC use, social communication challenges, behavioral context, and school or therapy support services for autistic clients.Start fromSpeech Therapy Intake Form
- Telehealth Pediatric Speech Session IntakeAsks about device availability, internet reliability, caregiver participation, and home practice capacity for remote pediatric speech services.Start fromSpeech Therapy Intake Form
- Corporate Voice and Presentation Coaching IntakeGathers professional speaking demands, vocal fatigue patterns, presentation anxiety level, and coaching goals for executive clients.Start fromSpeech Therapy Intake Form
- Traumatic Brain Injury Cognitive Communication IntakeDocuments TBI date, current cognitive concerns like memory and word finding, and return-to-work goals for post-TBI rehabilitation clients.Start fromSpeech Therapy Intake Form
- Early Intervention Speech Referral FormCollects parent concerns, age-appropriate developmental milestones not yet met, and pediatrician referral details for children under age 3.Start fromSpeech Therapy Intake Form
- Cleft Palate Speech Evaluation IntakeGathers surgical history, resonance concerns, and craniofacial team provider details for children with cleft palate and velopharyngeal dysfunction.Start fromSpeech Therapy Intake Form
- Individual Adult Therapy Intake FormCollects presenting concerns, symptom picture, and therapy goals for adults entering individual outpatient psychotherapy.Start fromTherapy Intake Form
- Couples Therapy Intake QuestionnaireGathers each partner's perspective on relationship strengths and challenges, communication patterns, and goals for couples counseling.Start fromTherapy Intake Form
- Child Therapy Intake (Parent-Completed)Asks parents to describe the child's presenting concerns, school functioning, developmental history, and family context before the first session.Start fromTherapy Intake Form
- Adolescent Therapy Intake FormUses age-appropriate language to ask teens directly about their concerns, relationships, school stress, and what they hope therapy will help with.Start fromTherapy Intake Form
- Trauma Therapy Intake FormIncludes detailed questions about trauma history, current PTSD symptoms, prior treatment attempts, and stabilization resources.Start fromTherapy Intake Form
- EMDR Therapy Pre-Intake QuestionnaireScreens for dissociation, trauma complexity, and stabilization capacity before beginning EMDR reprocessing work.Start fromTherapy Intake Form
- Grief Counseling Intake FormCaptures loss history, relationship to the deceased, grief timeline, and the client's support system during bereavement.Start fromTherapy Intake Form
- Substance Use Counseling Intake FormCollects substance use history, prior treatment attempts, current stage of change, and co-occurring mental health conditions.Start fromTherapy Intake Form
- EAP (Employee Assistance Program) Intake FormGathers employer EAP authorization information alongside presenting concerns for short-term work-focused counseling.Start fromTherapy Intake Form
- Online Therapy Platform Intake FormCollects technology comfort level, time zone, preferred appointment times, and communication preferences for virtual therapy clients.Start fromTherapy Intake Form
- Group Therapy Screening FormAssesses group fit by collecting interpersonal goals, prior group experience, and comfort with peer feedback before group placement.Start fromTherapy Intake Form
- Anger Management Intake QuestionnaireGathers information about anger triggers, frequency and intensity of anger episodes, and any legal or occupational consequences.Start fromTherapy Intake Form
- Sex Therapy Intake FormUses inclusive, judgment-free language to collect relationship structure, sexual concerns, medical factors, and treatment goals.Start fromTherapy Intake Form
- Faith-Based Counseling Intake FormAsks about spiritual practices, religious background, and how faith intersects with the presenting concerns for pastoral or faith-integrated therapy.Start fromTherapy Intake Form
- Mental Health Medication Refill FormCollects refill requests for antidepressants, mood stabilizers, or ADHD medications with a note field for any symptom changes.Start fromPrescription Refill Request Form
- Telehealth Mental Health Therapy ConsentUsed by therapists offering video sessions to document consent and gather presenting concerns before the first virtual therapy appointment.Start fromTelehealth Appointment Consent Form
- Physical Therapy Telehealth (Tele-PT) ConsentDocuments consent for remote physical therapy evaluation, noting the patient's home environment and available exercise equipment.Start fromTelehealth Appointment Consent Form
- Outpatient Psychiatry New Patient IntakeCollects complete psychiatric history, current symptom picture, and medication details before an initial psychiatric evaluation appointment.Start fromMental Health Intake Form
- Community Mental Health Center Intake FormDesigned for high-volume community mental health settings with a broad symptom screen and insurance and income-based payment fields.Start fromMental Health Intake Form
- ADHD Evaluation Pre-Assessment IntakeFocuses on attention, executive function, academic history, and prior ADHD diagnoses or treatments before a comprehensive ADHD evaluation.Start fromMental Health Intake Form
- PTSD and Trauma Specialty Intake FormIncludes trauma type screening, PTSD symptom checklist, current avoidance behaviors, and safety assessment for trauma-specialized practices.Start fromMental Health Intake Form
- Eating Disorder Treatment Program IntakeGathers eating behavior history, medical complications, prior treatment attempts, and body image concerns before an eating disorder evaluation.Start fromMental Health Intake Form
- Addiction and Dual Diagnosis Intake FormScreens substance use history, withdrawal risk, co-occurring psychiatric conditions, and prior detox or rehabilitation episodes.Start fromMental Health Intake Form
- Child Psychiatric Evaluation Intake (Parent-Completed)Collects developmental history, school performance, behavioral concerns, and family psychiatric history for a child's initial psychiatric evaluation.Start fromMental Health Intake Form
- College Counseling Center Mental Health IntakeUses age-appropriate language to collect academic stressors, social functioning, sleep, and substance use for college student clients.Start fromMental Health Intake Form
- Perinatal Mental Health Intake FormScreens for postpartum depression, anxiety, OCD, and psychosis with questions specific to pregnancy and the postnatal period.Start fromMental Health Intake Form
- Geriatric Mental Health Intake FormAssesses cognitive changes, late-life depression, grief, polypharmacy, and social isolation for older adult clients in geriatric psychiatry settings.Start fromMental Health Intake Form
- First Responder Mental Health Intake FormUses occupationally sensitive language to reduce stigma for police, firefighters, and paramedics seeking mental health support.Start fromMental Health Intake Form
- LGBTQ+ Affirming Mental Health Intake FormIncludes inclusive gender identity and sexual orientation fields with trauma-informed framing to welcome LGBTQ+ clients from the first touchpoint.Start fromMental Health Intake Form
- Residential Treatment Pre-Admission IntakeCollects medical clearance information, current crisis level, substance use, and treatment motivation for residential program admissions.Start fromMental Health Intake Form
- Online/Virtual Therapy Platform Mental Health IntakeGathers technology comfort, time zone, scheduling preferences, and crisis support resources available to the client for remote therapy onboarding.Start fromMental Health Intake Form
- Solo Therapist Intake FormGive a single-practitioner counseling practice a short pre-session form that skips insurance and conditions fields entirely.Start fromPrivacy-First Patient Intake Form
- Mental Health Service Referral FormTake clinician referrals where the contact-preference field matters most — some patients cannot safely take a call about a referral at home.Start fromPatient Referral Form
- Speech and Language Therapy Referral FormTake referrals for children and adults, using the interpreter and communication-needs field to plan the first session properly.Start fromPatient Referral Form
- Hand Therapy Intake FormTrim the body region dropdown to wrist, hand and elbow and keep the three pain scores for a specialist upper-limb caseload.Start fromPhysiotherapy Intake Form
- Community Occupational Therapy Referral IntakeCollect the activities affected and the home setup before a community OT decides whether the first contact is a visit, a call or an equipment order.Start fromOccupational Therapy Intake Form
- Hospital Discharge OT Assessment FormRecord the home environment, existing adaptations and who is around to help, so a discharge plan is not built on assumptions about the house.Start fromOccupational Therapy Intake Form
- Housing Adaptation Assessment IntakeCapture home type, stairs, existing rails and ramps, and the transfers that are failing, ahead of an adaptations assessment.Start fromOccupational Therapy Intake Form
- Stroke Rehabilitation Intake FormUse the movement and organisation checklists alongside the activities list to prepare a first neurological rehabilitation session.Start fromOccupational Therapy Intake Form
- Paediatric Occupational Therapy IntakeKeep the proxy questions, trim the activities list to dressing, feeding, school and play, and let a parent describe the hardest part in their own words.Start fromOccupational Therapy Intake Form
- Vocational Rehabilitation Intake FormCombine the work environment field with the activities list to plan a phased return that reflects the actual job, not the job title.Start fromOccupational Therapy Intake Form
- Hand Therapy OT Intake FormCut the mobility items and keep grip, writing, typing, dressing and cooking for an upper limb caseload.Start fromOccupational Therapy Intake Form
- Reablement Service Intake FormRecord which self-care tasks currently need help and what equipment is already in the house before a short-term reablement package starts.Start fromOccupational Therapy Intake Form
- Home Visit Preparation FormUse the access field for steps, parking, pets and entry arrangements so the first visit is not wasted at the front door.Start fromOccupational Therapy Intake Form
- Assistive Equipment Assessment IntakeList what the person already uses before recommending anything new, and pair it with the transfers and mobility answers.Start fromOccupational Therapy Intake Form
- Neurodivergent Adult OT IntakeUse the sensory checklist and the organisation checklist together to plan support around environment and routine rather than diagnosis.Start fromOccupational Therapy Intake Form
- Private OT Practice Enquiry FormLet a self-referring client describe what they want to be able to do again before the first paid appointment is booked.Start fromOccupational Therapy Intake Form
- Carer-Completed Intake FormGive a relative or paid carer a form that records who they are and their relationship, so the clinical team reads the answers in the right voice.Start fromOccupational Therapy Intake Form
- Couples Counselling First-Session IntakeRecord both partners, how long the difficulty has lasted, and each person's goal in their own words before session one.Start fromCouples & Family Therapy Intake Form
- Marriage Counselling Intake FormCollect relationship length, what changed recently, and whether both spouses have agreed to attend.Start fromCouples & Family Therapy Intake Form
- Pre-Marital Counselling IntakeUse the topic checklist and separate goal fields to surface where a couple already knows they disagree.Start fromCouples & Family Therapy Intake Form
- Family Therapy Intake (Parent-Completed)Let a parent list everyone attending with ages and relationships, and leave space for a young person's own goal.Start fromCouples & Family Therapy Intake Form
- Blended Family Therapy IntakeCapture step-parenting and household arrangements in the participants field, where a single client-name box would lose them.Start fromCouples & Family Therapy Intake Form
- Co-Parenting After Separation IntakeRecord two separated adults, their separate goals, and whether it is safe to leave messages on either number.Start fromCouples & Family Therapy Intake Form
- Discernment Counselling IntakeUse the 'deciding whether to separate' topic and the disagreement field for couples who are not yet agreed on the work itself.Start fromCouples & Family Therapy Intake Form
- Parent and Adolescent Therapy IntakeCollect the parent's account and the young person's goal separately rather than merging them into one narrative.Start fromCouples & Family Therapy Intake Form
- Online Couples Therapy Intake FormGather participants, goals and contact boundaries before a first video session, alongside a telehealth consent form.Start fromCouples & Family Therapy Intake Form
- Faith-Based Marriage Counselling IntakeUse the cultural, faith and identity topic option and the free-text goals for pastoral counselling services.Start fromCouples & Family Therapy Intake Form
- Relationship and Intimacy Therapy IntakeRecord the presenting concern and each partner's goal with a topic list that names intimacy explicitly rather than implying it.Start fromCouples & Family Therapy Intake Form
- Bereavement Family Support IntakeUse the participants field for a whole household and the 'why now' field to record the loss that prompted contact.Start fromCouples & Family Therapy Intake Form
- EAP Relationship Counselling IntakeCollect the same joint history for an employer-funded programme, with contact boundaries that keep sessions private from a shared home phone.Start fromCouples & Family Therapy Intake Form
- Community Family Services IntakeRecord which other professionals are already involved so a low-cost service can join up with social care or school support.Start fromCouples & Family Therapy Intake Form
Human Resources form templates
- Engineering Team Safety BaselineEstablish whether an engineering team can actually raise a risk before you introduce blameless postmortems, so you can tell later whether the practice changed anything.Start fromTeam Psychological Safety Survey
- Post-Incident Team SurveyRun the seven items a few weeks after a serious incident to check whether the response made people more willing to report the next one, or less.Start fromTeam Psychological Safety Survey
- New Team Formation CheckMeasure a team assembled from several groups at three months, when the polite phase ends and the real norms are setting.Start fromTeam Psychological Safety Survey
- Agile Coaching Engagement BaselineGive a coach a measured starting point for a team, instead of an impression formed in two retrospectives.Start fromTeam Psychological Safety Survey
- Clinical Team Speak-Up SurveyCheck whether junior staff on a clinical team believe they can challenge a decision, in wording you can repeat unchanged six months later.Start fromTeam Psychological Safety Survey
- Post-Merger Team Climate SurveyTest whether people from the acquired side of a merged team think their particular strengths are actually being used, six months after the reporting lines changed.Start fromTeam Psychological Safety Survey
- Retrospective Preparation SurveyCollect the seven scores and the held-back question before a retrospective, so the facilitator knows in advance whether the room will actually talk.Start fromTeam Psychological Safety Survey
- Remote Team Voice CheckFind out whether a distributed team raises problems or quietly routes around them, when none of the usual corridor signals are available.Start fromTeam Psychological Safety Survey
- Manager Handover CheckTake a reading before a team changes manager and again three months after, so the incoming lead inherits a trend rather than an anecdote.Start fromTeam Psychological Safety Survey
- Pre and Post Intervention MeasurementRun the same seven items before and after a deliberate change to how a team meets or decides, and compare the two team averages.Start fromTeam Psychological Safety Survey
Social Services form templates
- School Counselor Community Referral FormAllows school counselors to connect at-risk students and families to outside mental health, food, or housing support with parental consent documented.Start fromService Referral Form
- Mental Health Crisis Walk-In IntakeCaptures presenting crisis, prior psychiatric history, and immediate safety status for individuals presenting at a community mental health walk-in center.Start fromCrisis Support Intake Form
- Grief and Bereavement Crisis IntakeDocuments sudden loss circumstances, existing support systems, and immediate mental health needs for individuals in acute grief following traumatic bereavement.Start fromCrisis Support Intake Form
- Postpartum Mental Health Crisis IntakeDocuments postpartum depression or psychosis symptoms, infant safety concerns, and support network availability for new parents in mental health crisis.Start fromCrisis Support Intake Form
- Mental Health After-School Group EnrollmentRegisters youth for school-community partnership social-emotional learning groups with parental consent and therapist contact if applicable.Start fromAfter-School Program Enrollment Form
Research & Science form templates
- Psychology Attitude Measurement SurveyMeasures participants' implicit and explicit attitudes toward a social group using validated Likert-scale items aligned with published psychometric instruments.Start fromAcademic Research Survey
- Mental Health Intervention Study ScreeningScreens for depression severity scores, prior therapy history, current psychiatric medications, and absence of active suicidality for a CBT intervention trial.Start fromClinical Trial Screening Form
- Psychology Deception Study ApplicationDocuments the specific deception employed, the debriefing script, and the psychological risk mitigation plan for an experiment involving false feedback to participants.Start fromIRB / Ethics Review Application
- Psychology Experiment Debrief FeedbackCollects participant reactions to a deception study, including whether the post-experiment debriefing fully resolved any distress caused by the experimental manipulation.Start fromResearch Study Participant Feedback
Community form templates
- Mental Health Awareness Month Sign-Up FormCollect supporters who want to share their mental health journey, join panel discussions, or distribute awareness resources in their workplace or school.Start fromCampaign Awareness Sign-Up Form
- Veteran Mental Health Awareness Sign-Up FormEnroll service members, veterans, and civilian supporters in a peer support network and public education campaign, capturing branch of service and preferred involvement.Start fromCampaign Awareness Sign-Up Form
- Therapeutic Horticulture Program EnrollmentRegisters participants in a mental health–focused gardening program, capturing therapeutic goals and any physical limitations.Start fromCommunity Garden Plot Request Form
What therapists & mental health usually collect
Presenting concerns and goals
Why the client is coming now, symptom picture, previous treatment attempts, current medications and what they want from therapy. Speech and language intakes swap this for milestones, phonological patterns and prior evaluations.
Consent and agreements
Telehealth consent before a first video session, parental consent on a school referral, study participation consent in a research lab. A checkbox records that someone read and agreed; it is not a legally-executed signature.
Safety and risk detail
Walk-in and crisis intakes capture the presenting crisis, prior psychiatric history and immediate safety status. Put those questions on an end-to-end encrypted form, and keep a visible line about what to do in an emergency.
Practical session logistics
Device availability, internet reliability, time zone and who else will be in the room for a remote session. Employer EAP authorisation, insurance details or an income band where fees slide.
29 templates to start from
- Couples & Family Therapy Intake FormIntake for two or more people in the room — who is attending, each person's goal, and contact boundaries.
- Mental Health Intake FormGather presenting concerns, history, and safety information before first mental health appointments.
- Therapy Intake FormGather client background and goals before the first therapy session.
- Occupational Therapy Intake FormMap the daily activities that have become difficult, the home and work environment, and what the person most wants to do again.
- Speech Therapy Intake FormGather client history and communication concerns before a first speech therapy session.
- Team Psychological Safety SurveySeven scored statements on blame, speaking up, difference, risk, asking for help and how strengths get used, run at team level.
- Crisis Support Intake FormCapture crisis type, safety status, and support needs for urgent case coordination.
- Campaign Awareness Sign-Up FormBuild your campaign supporter list and discover how people want to take action.
- Patient Referral FormFor referring clinicians: reason, urgency, records handoff and patient consent.
- Telehealth Appointment Consent FormCollect informed consent and appointment details before virtual visits.
- Academic Research SurveyCollect participant data for academic studies with informed consent built in.
- After-School Program Enrollment FormEnroll children in after-school programs with medical, schedule, and permission details.
- Clinical Trial Screening FormScreen potential clinical trial participants for eligibility quickly and compliantly.
- Coaching Discovery Call Request FormLet prospects request a discovery call and share their challenges and goals upfront.
- Community Garden Plot Request FormManage plot applications for your community garden with ease.
- CSA Membership Sign-UpSign up new CSA members with share size, pickup, and add-on preferences.
- Health Risk AssessmentAssess lifestyle health risks across exercise, diet, sleep, and medical history.
- IRB / Ethics Review ApplicationCollect structured research ethics applications for IRB review committees.
- Life Coaching Intake FormGather client background, goals, and challenges before the first coaching session.
- Parent-Teacher Conference RequestLet parents schedule teacher meetings and share discussion topics in advance.
- Physiotherapy Intake FormCollect complaint, mechanism, pain scores, aggravating factors and goals before a first physiotherapy appointment.
- Prayer Request FormCollect and organize prayer requests from your congregation.
- Prescription Refill Request FormLet patients request prescription refills online, anytime.
- Privacy-First Patient Intake FormCollect only what a first visit needs, plus a privacy acknowledgement.
- Research Study Consent FormCollect informed consent from research participants with full IRB-ready detail.
- Research Study Participant FeedbackCollect participant experience feedback after a research study session.
- Service Referral FormAllow professionals to refer clients to your agency with full context.
- Small Group Sign-UpMatch congregation members with the right small group based on preferences.
- Webinar Speaker Application FormAccept and evaluate speaker proposals for webinars and virtual learning events.
How to set one up
- 1
Open the Therapy Intake Form or the Mental Health Intake Form, whichever is closer to your caseload, and rewrite the presenting-concerns questions in the language you actually use with clients.
- 2
Branch the form by who is filling it in: a parent completing a child intake gets developmental history and school functioning, a teen answering for themselves gets none of that and plainer wording for the questions that remain.
- 3
Put the history sections on an end-to-end encrypted form, and add a File Upload field where you need the paperwork itself — a prior speech evaluation, a GP referral letter, a discharge summary. Attachments on an encrypted form are encrypted too, and decrypt in your browser.
- 4
Send the link in your booking confirmation email, or embed the form on your practice site with two lines of HTML. A QR code works for walk-in and waiting-room intake.
- 5
Set a webhook so each submission lands in your practice management tool or notifies the duty clinician, then filter responses by date when you prepare for a first session.
Frequently asked questions
Is formformform HIPAA compliant?
No. No business associate agreement is on offer, and there is no HIPAA programme, SOC 2 report or ISO certificate behind the product. What exists is GDPR compliance, optional EU hosting, encryption at rest and in transit, and end-to-end encrypted forms. If your practice holds protected health information under HIPAA, use a tool that will sign a BAA.
Can the form score a PHQ-9 or GAD-7?
No. Item responses arrive unscored — there is no calculated-field or scoring engine behind them. You can still reproduce the instrument's exact wording and response options, export the submissions, and total them in your notes or your practice record, which is where the score belongs anyway.
How do I document consent for telehealth sessions?
A consent form can present your telehealth terms and record a checkbox agreement with the submission, alongside the practical questions — device, connection, who else is at home. Treat it as documented consent, not an e-signature: there are no signature fields, and formformform is not a signing product.
How do I collect intake from both partners in couples therapy?
Send each partner the same link and ask for their name at the top, so the two perspectives arrive as separate submissions rather than one negotiated answer. Put a question near the start asking whether they are the first or the second partner to fill it in, and logic can skip the shared relationship-history block the second time. Filter responses by name to read them side by side.
Can clients book and pay for a session through the form?
Clients can pay through secure hosted checkout with Stripe, PayPal, or Square. Scheduling is separate: collect preferred days and contact details, then use a webhook or your existing booking tool to confirm the session.
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