About this template
The Hypnotherapy Intake Google Form template is designed to streamline the onboarding process for hypnotherapists and wellness practitioners. By gathering essential client history, health background, and specific therapeutic goals before the initial session, practitioners can maximize their time during consultations and provide more personalized care.
This form covers critical areas including contact information, medical history, current medications, sleep patterns, and family dynamics. It also provides space for clients to articulate their specific concerns and past experiences with hypnotherapy. Using this template allows you to maintain organized, digital records that are easily accessible, helping you build a comprehensive understanding of each client's needs before they even walk through your door.
Key features
- Comprehensive health and medical history tracking
- Dedicated sections for therapeutic goals and problem areas
- Easy-to-use digital format for pre-session preparation
- Mobile-friendly design for client convenience
- Fully customizable to match your practice's branding
Use cases
- New client onboarding for private hypnotherapy practices
- Gathering pre-session health and medication data
- Assessing client goals and expectations for therapy
- Collecting background information on sleep and family history
What this form collects
- Full Name (Short answer)Please provide your full legal name.
- Date of Birth (Date)Format: MM/DD/YYYY
- Contact Information (Paragraph)Provide your preferred email and phone number for session reminders.
- Current Health Status (Paragraph)Briefly describe your current physical and mental health status.
- Current Medications (Paragraph)List any medications you are currently taking.
- Primary Goals for Hypnotherapy (Paragraph)What do you hope to achieve through our sessions?
- Have you experienced hypnotherapy before? (Multiple choice)Select your experience level.
- Sleep Patterns (Paragraph)How would you describe your typical sleep quality?
- Additional Concerns (Paragraph)Is there anything else you would like me to know before our first meeting?
FAQ
Is this form template secure?
Google Forms provides robust security features. However, always ensure you are following your local healthcare data privacy regulations when handling sensitive client information.
Can I add my own questions to this template?
Yes, once you copy the template to your Google Drive, you can add, remove, or edit any questions to better suit your specific practice requirements.
How do I share this form with my clients?
You can share the form via a direct link in your welcome email, or embed it directly onto your professional website for easy access.
Can I export the data collected?
Absolutely. All responses are automatically saved to a Google Sheet, allowing you to easily organize, filter, and review client data.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.