Mental Health Intake Form Template: Complete Guide (+ Free Template)

Looking for an effective intake form template that you can use today?

The intake form is often a client's first tangible connection with therapy — a bridge between considering help and beginning their healing journey.

While it serves practical purposes, it's also an opportunity to demonstrate the care, thoroughness, and professionalism that will characterize your therapeutic relationship.

What is an intake form for counseling and therapy? A brief recap

An intake form is a foundational document for your therapy practice.

It collects personal, medical, and psychological information from clients before starting therapy sessions.

As you know, you need an intake form for new client onboarding. It can ensure legal compliance, gather essential background information, and help when creating personalized treatment plans for clients.

Aside from the necessity of having an intake form for clients, you'll want one to make your practice easier for you.

So, what are the necessary pieces of information you need to include on your intake form?

Client intake form example

Your intake form is more than a collection of questions - it's a thoughtful framework that guides both you and your client through that crucial first meeting.

Think of the intake form as a collaborative map for your biopsychosocial assessment. By collecting key information before or during the session, you create space for deeper exploration of what matters most.

Once completed, this information flows naturally into your biopsychosocial assessment, helping you identify patterns, recognize strengths, and spot potential barriers to treatment early. Rather than approaching intake as a checklist, consider it the foundation of your therapeutic alliance — each question opening a door for deeper understanding and connection.

What should a client intake form ask about?

A well-designed intake form serves as both a practical tool for gathering essential information and a thoughtful framework for understanding your client's full story. Here's what your intake form should include:

Basic Information and Safety

• Client's legal name and preferred name for addressing them
• Contact details (address, phone, email)
• Date of birth and age
• Pronouns and gender identity (optional)
• Preferred language
• Emergency contact information
• Accessibility needs for sessions

Presenting Concerns and Goals

• Primary reason for seeking therapy
• Timeline of when challenges began
• Life areas most impacted by current challenges
• Current thoughts of self-harm or suicide
• Presence of any current crisis
• Specific short-term and long-term therapy goals
• What success in therapy would look like for them

Medical and Health Background

• Current medical conditions and hospitalizations
• Current medications (including name, dosage, frequency, prescribing doctor)
• Previous psychiatric medications
• Physical health self-assessment
• Exercise habits and physical activity
• Diet and nutrition patterns
• Sleep patterns and any sleep-related challenges

Mental Health History

• Previous mental health services or treatment
• Previous mental health diagnoses
• History of self-harm or suicidal thoughts
• Trauma or significant loss experiences
• Substance use patterns
• Family mental health history
• History of suicide attempts in family

Social and Environmental Context

• Current living situation and safety
• Employment status and satisfaction
• Educational background
• Military service history
• Cultural and spiritual practices
• Important relationships and support systems
• Transportation access
• Financial or housing challenges
• Food security
• Current legal challenges

Coping and Strengths

• Typical ways of handling stress
• Current support systems
• Cultural or spiritual resources
• Activities and interests

Insurance and Payment Information

• Primary insurance details
• Secondary insurance (if applicable)
• Insurance verification information
• Payment preferences and methods
• Understanding of coverage limits and requirements

By gathering this information thoughtfully and systematically, you create a foundation for understanding your client's needs while demonstrating your commitment to providing comprehensive care. Remember that each question serves not just as data collection, but as an opportunity to begin building therapeutic rapport and understanding your client's unique story.

Go above and beyond with these intake questions

If you're reading this far, you're clearly committed to creating an intake process that truly serves your clients. Let's explore how to make the most of the questions in your intake form template, going beyond basic data collection to build genuine therapeutic connection.

Therapeutic goals

Understanding a client's therapeutic goals is crucial for tailoring the therapy process to meet their specific needs. Your intake form already includes these essential questions that help uncover these goals:

1. "If you could accomplish one thing in therapy, what would it be?"
2. "What are your short-term goals/needs for therapy?"
3. "What are your long-term goals/needs for therapy?"

These questions lay the foundation for clarity, focus, and measurable progress. They also give clients the space to articulate their hopes for therapy in their own words, helping them feel heard and understood from the very beginning.

Mental health history

Gathering detailed information about a client's mental health history is essential for understanding their journey and planning effective treatment. Your intake form thoughtfully addresses this through questions about:

• Previous mental health services and treatments
• Past and current mental health diagnoses
• History of self-harm or suicidal thoughts
• Family mental health history, including suicide attempts
• Current symptoms and challenges

The form's careful attention to both personal and family history helps create a complete picture of your client's mental health landscape.

Important relationships and social support

Your intake form includes comprehensive questions about relationships and support systems, asking clients to:

• Identify significant relationships in their life
• Rate the quality of these relationships
• Discuss any specific relationships they'd like to explore in therapy
• Share their living situation and who they live with
• Describe their support systems

This social context is invaluable for understanding your client's resources and challenges.

Environmental and practical factors

The template already thoroughly addresses environmental factors that can impact mental health through questions about:

• Safety in current living situation
• Access to transportation
• Financial or housing challenges
• Food security
• Current legal challenges
• Employment status and satisfaction
• Educational background
• Cultural and spiritual practices

These questions help identify potential barriers to treatment and areas where additional support might be needed.

Remember that while these questions provide essential information, how you use this information matters most. Each response offers an opportunity to demonstrate empathy, build trust, and begin crafting a therapeutic approach that honors your client's unique experiences and needs.

When reviewing a client's responses, consider not just the content but the context - what might these answers tell you about their resilience, their challenges, and their readiness for change? This deeper understanding will help you create a more effective and personalized therapeutic experience from day one.

Implementing and reviewing intake forms

Now that you know what exactly to include on your intake form and have seen an example, how can you put your intake form to work for your practice?

Integration: Adding intake forms into your workflows

First up, let’s integrate your new intake form template into your workflow. That means making it a regular part of the way you do things in your practice.

• Digitize it: Use electronic health record (EHR) systems to digitize the process or use a note-taking platform like Upheal to help with the intake note data collection. This not only makes it easier to manage but also ensures that forms are easily accessible and can be updated as needed.
• Use a process: Establish a standardized procedure for clients to fill out intake forms. This can be done online before the first session or as part of the initial appointment. Ensure that all staff members are trained in this process to maintain consistency.
• Automate reminders: Set up automated reminders for clients to complete their intake forms before their appointment. This can be done through email or SMS, reducing no-shows and incomplete forms.

By including your intake form in your normal processes, you can ensure they’ll be filled out and help you help your clients.

Reviewing: Check your forms for accuracy and relevance

Things change all the time in mental health. Laws, modalities, and clinical experience all play a role.

To ensure you’re staying up to date, implement these measures:

• Review yearly: Schedule annual reviews of your intake forms to ensure they remain relevant and up-to-date with current practice standards, legal requirements, and your practice's needs.
• Update legal and ethical aspects: Stay informed about changes in legal and ethical standards related to client intake and documentation. Update your forms accordingly to maintain compliance.
• Use a feedback loop: Incorporate feedback from clients and staff to identify any areas of improvement. Regularly solicit input to ensure the forms are user-friendly and comprehensive.
• Pilot test your form: Before implementing significant changes, pilot test the updated forms with a small group of clients to gather feedback and make necessary adjustments.

These are some best practices when reviewing and updating your forms. Keeping your intake form template top-notch doesn’t have to be hard, as these practices show.

Feedback: Using client feedback to improve the intake process

What is a good process with no feedback? 

We want to make sure that the intake form we use works for us and for our clients. 

Here’s how to do just that:

• Surveys and questionnaires: After the intake process, send out brief surveys to clients asking about their experience. Questions can focus on ease of use, clarity of questions, and any areas they found confusing or cumbersome. Even 1-2 questions can help you gather insights.
• Therapist input: Gather feedback from therapists on how well the intake forms are working in practice. Are they getting the information they need? Are there redundant or missing questions?
• Continuous improvement: Use the feedback to make incremental improvements. This ensures that the forms evolve with the practice and continue to meet the needs of both clients and therapists.

Put your findings to work by experimenting with new ways of doing things. 

If clients complain that your intake form is too long, consider adding “optional” next to a few sections, for example.

Always look to improve your forms and processes for a great intake session, smooth client onboarding, and a great experience all around.

Final notes about therapy intake forms

The intake form is more than paperwork — it's often the first chapter in a client's healing journey. When thoughtfully designed, it creates a foundation of trust, understanding, and safety that ripples throughout the therapeutic relationship.

We know the challenge: documentation can pull us away from being fully present with our clients during those precious early moments. Yet thorough intake notes support better outcomes and help us provide the highest standard of care. The magic happens when we find that sweet spot between gathering necessary information and nurturing genuine human connection.

Looking to maintain that crucial human connection while streamlining your documentation? Upheal's AI-powered platform can help you reclaim up to 40 hours per month — time you can reinvest in client care and your own wellbeing. Try Upheal free today to discover how you can reduce administrative burden while keeping the heart of therapeutic work at the center of your practice.