What to include in a therapy intake form

An intake form has two jobs. It gives you enough to prepare for the first session, and it records the basics you need to work safely: who the client is, how to reach them, and who to call in an emergency. Everything beyond that is optional, and every extra question makes the form a little less likely to come back complete.

What you are required to collect, and how you have to store it, depends on where you practise. Check with your licensing body or professional association. Treat the list below as a starting point rather than a legal standard.

The essentials

• Full name, and the name they would like you to use
• Date of birth
• Phone number and email, and which one they prefer
• Address, if you need it for invoices or home visits
• Emergency contact, with their relationship to the client and a phone number
• Their doctor, if you may need to coordinate care
• How they found you, which also tells you which referral sources are working

Clinical background

Keep these questions open. A short text box gets more honest answers than a long list of tick boxes.

• What brings you to therapy now?
• What would you like to be different by the end of it?
• Have you had counselling or therapy before? What helped, and what did not?
• Current medication, and who prescribes it
• Any physical health conditions that affect how you feel day to day
• Alcohol or other substance use, asked plainly and without judgement

Risk

Many therapists include one simple screening question, such as whether the client has had thoughts of harming themselves recently, and follow it up in person. If you include it, read forms before the session rather than during it, and know in advance what you will do if the answer is yes.

Consent and practical terms

• Your confidentiality policy and its limits, in plain language
• Fees, how payment works, and your cancellation policy
• How you will contact them, and whether you can leave messages
• How you store their records and for how long
• A signature and date, or an online confirmation that does the same job

What to save for the first session

Detailed history, family background, relationships, trauma, and anything else that needs context is better explored in the room. Asking for it on a form can feel intrusive before there is any trust, and the answers are usually thinner than what you would hear by asking in person.

Keep it short

If a form takes more than ten minutes, people put it off. Aim for one page of essentials and a handful of open questions. You can always ask more later.

It also helps to have somewhere for the answers to go, so the details sit on the client's record instead of in your inbox. In MindMaster a name is enough to create a client, and intake details can be added whenever you have them.