Therapy Intake Form Template

Help new clients feel heard from the very first interaction. This therapy intake form invites clients to describe what brings them to therapy in their own words, identify current symptoms, share relevant history, and indicate their therapy type preference — giving therapists essential context before the first session even begins.

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Who uses this template

Licensed professional counselorsLicensed clinical social workersPsychologistsMarriage and family therapistsTrauma-specialized therapistsPrivate practice group practicesCommunity mental health centersEmployee Assistance Programs (EAPs)

About this template

A therapy intake form does double duty: it collects the clinical and administrative information a practice needs to prepare for a new client, and — if written well — it begins the therapeutic relationship with warmth rather than bureaucracy. The language and structure of the form send a message about what the therapy experience will feel like. This template prioritizes client-centered phrasing: 'What brings you to therapy at this time?' rather than 'Chief complaint.'

Clinically, the form covers the core elements any therapist needs before a first session: presenting concerns, current symptom picture, relevant personal and family history, prior therapy experience, and payment logistics. The symptom checklist is broad enough to surface issues the client might not have thought to mention explicitly, while the open-ended text field gives them space to describe their experience in their own words — often the most useful clinical data of all.

formformform is an ideal tool for therapy practices that want to professionalize their intake process without investing in expensive practice management software. You get a clean, mobile-friendly form, instant email notification when a client submits, and a searchable submission dashboard — all free. The form can be sent via a link in your scheduling confirmation email or embedded on your website's new client page.

14 form ideas you can build with this template +
Individual Adult Therapy Intake Form

Collects presenting concerns, symptom picture, and therapy goals for adults entering individual outpatient psychotherapy.

Couples Therapy Intake Questionnaire

Gathers each partner's perspective on relationship strengths and challenges, communication patterns, and goals for couples counseling.

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.

Adolescent Therapy Intake Form

Uses age-appropriate language to ask teens directly about their concerns, relationships, school stress, and what they hope therapy will help with.

Trauma Therapy Intake Form

Includes detailed questions about trauma history, current PTSD symptoms, prior treatment attempts, and stabilization resources.

EMDR Therapy Pre-Intake Questionnaire

Screens for dissociation, trauma complexity, and stabilization capacity before beginning EMDR reprocessing work.

Grief Counseling Intake Form

Captures loss history, relationship to the deceased, grief timeline, and the client's support system during bereavement.

Substance Use Counseling Intake Form

Collects substance use history, prior treatment attempts, current stage of change, and co-occurring mental health conditions.

EAP (Employee Assistance Program) Intake Form

Gathers employer EAP authorization information alongside presenting concerns for short-term work-focused counseling.

Online Therapy Platform Intake Form

Collects technology comfort level, time zone, preferred appointment times, and communication preferences for virtual therapy clients.

Group Therapy Screening Form

Assesses group fit by collecting interpersonal goals, prior group experience, and comfort with peer feedback before group placement.

Anger Management Intake Questionnaire

Gathers information about anger triggers, frequency and intensity of anger episodes, and any legal or occupational consequences.

Sex Therapy Intake Form

Uses inclusive, judgment-free language to collect relationship structure, sexual concerns, medical factors, and treatment goals.

Faith-Based Counseling Intake Form

Asks about spiritual practices, religious background, and how faith intersects with the presenting concerns for pastoral or faith-integrated therapy.

What's included

+ Open-ended 'reason for seeking therapy' field honors client voice
+ Symptom checklist covers the most common presenting concerns
+ Therapy type preference dropdown helps with clinician matching
+ Referral source field supports tracking intake pathways
+ Payment and insurance checkbox streamlines administrative intake
+ Emergency contact field for safety planning
+ Warm, accessible language reduces barrier for first-time clients

How to create a therapy intake form

  1. 1

    Click "Use this template" to build on this foundation in the formformform editor.

  2. 2

    Adjust the symptom checklist to reflect the areas your practice specializes in — add trauma-specific items for a PTSD specialty practice, or relationship-focused items for a couples therapy practice.

  3. 3

    Add a consent or confidentiality notice paragraph so clients understand the limits of confidentiality before they share personal details.

  4. 4

    Configure email notifications to alert your intake coordinator or directly to the assigned therapist.

  5. 5

    Send the form link to new clients after they schedule their first appointment — give them at least 24 hours to complete it thoughtfully.

  6. 6

    Publish the form link and share it as part of your new client welcome sequence or embed it on your website.

Best practices for your therapy intake form

Use warm, accessible language

avoid clinical jargon in field labels. 'What brings you to therapy right now?' invites more honest answers than 'Chief complaint'.

Don't make personal history fields required

new clients may not feel safe sharing trauma history on an online form. Make these optional and revisit them in session.

Include a brief confidentiality statement

a short paragraph explaining that responses are private and covered by therapist-client privilege helps clients feel safe filling out the form honestly.

Ask about previous therapy

knowing if a client has had positive or negative experiences before helps therapists calibrate their approach and avoid repeating what didn't work.

Collect emergency contact information carefully

frame this as standard practice for all clients rather than singling out clients who may be at risk, which can feel stigmatizing.

Review the form before the first session, not during it

arriving prepared lets the therapist spend the session hour building rapport rather than gathering background facts.

Frequently asked questions

Is a therapy intake form the same as a mental health intake assessment? +

A therapy intake form collects background, presenting concerns, and logistics before the first session. A mental health intake assessment is a more formal clinical evaluation (often using standardized measures like PHQ-9 or GAD-7) typically completed with the therapist during the first appointment. You can add standardized screening tools to this form if needed.

Can I include a HIPAA notice and consent to treatment in this form? +

Yes. Add a paragraph field with your HIPAA notice text, then add a checkbox field for the client to acknowledge it. You can mark the acknowledgment checkbox as required so the form can't be submitted without it.

How do I match this form to my specialty — couples therapy, child therapy, trauma, etc.? +

Duplicate the template and customize it for each specialty. A couples therapy intake would ask about relationship length, prior counseling, and each partner's goals. A child therapy version would collect parent information and developmental history.

Can clients save their progress and return to finish the form later? +

Currently forms must be completed in one session, so advise clients to set aside 10-15 minutes before starting.

What if a client discloses a safety concern in the form? +

The form is not a substitute for a real-time clinical assessment of safety. If you are concerned about a client's safety, contact them directly before their scheduled appointment. You can add a note in the form instructions recommending clients call 988 or 911 for immediate crises.

Can I send different intake forms to different client types? +

Yes. Create multiple versions of this template — one for individual clients, one for couples, one for adolescents — and send the appropriate link based on the appointment type.

Related templates

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