About this template
Streamline your mental health practice onboarding with a structured psychotherapy intake form. Designed specifically for therapists, counselors, and mental health clinics, this template helps you gather vital background information, emergency contacts, medical history, and presenting concerns before the first session. By collecting this information digitally ahead of time, practitioners can review client details securely and dedicate more time during the initial appointment to building rapport and outlining treatment goals.
With Doc2Form, you can instantly turn this template into a ready-to-use Google Form, making it simple to share securely via email or embed on your practice website. Clients can complete the questionnaire comfortably from their phone, tablet, or computer prior to arriving for an in-person session or joining a telehealth call. Transitioning away from clipboards and paper paperwork reduces administrative friction, minimizes data entry errors, and helps new clients feel prepared and welcomed before therapy begins.
Key features
- Collect client contact info and emergency contacts in one secure step
- Gather medical history and presenting concerns prior to the first session
- Fully customizable questions to match your unique clinical approach
- Accessible on all devices for easy remote or in-office completion
- Seamlessly integrated with Google Drive for organized client record management
Use cases
- Private psychotherapy and mental health counseling practices
- Telehealth therapy sessions and virtual consultations
- Initial client onboarding for community mental health centers
- Student counseling centers and university psychology clinics
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Enter your date of birth.
- Phone Number (Short answer)Enter the best phone number to reach you.
- Email Address (Short answer)Enter your primary email address.
- Mailing Address (Paragraph)Enter your current street address, city, state, and ZIP code.
- Emergency Contact Name & Relationship (Short answer)Provide the name and relationship of someone we can contact in case of an emergency.
- Emergency Contact Phone Number (Short answer)Enter a reachable phone number for your emergency contact.
- What brings you to therapy at this time? (Paragraph)Briefly describe your primary concerns, symptoms, or goals for counseling.
- Have you previously attended psychotherapy or counseling? (Multiple choice)Select the option that best describes your experience.
- Current Medical Conditions & Medications (Paragraph)List any medical conditions, psychiatric diagnoses, or medications you are currently taking.
- Preferred Session Format (Multiple choice)Choose your preferred method for attending therapy sessions.
- Acknowledgement of Practice Policies (Short answer)Type your full legal name below to confirm you have reviewed our intake policies, confidentiality guidelines, and cancellation terms.
FAQ
What is a psychotherapy intake form?
It is a questionnaire used by mental health professionals to collect essential background information, contact details, medical history, and reasons for seeking therapy from new clients before their first appointment.
How do I share this form with my clients?
Once generated with Doc2Form, you can easily share the Google Form via a direct link in your appointment confirmation emails or embed it directly onto your practice's website.
Can I customize the questions on this template?
Yes! Because the template is generated as a Google Form, you have full freedom to add, remove, or edit any questions to suit your specific practice requirements.
Is this intake form suitable for telehealth appointments?
Absolutely. Clients can fill out and submit the form securely from their own devices prior to joining a virtual video session, eliminating the need for physical paperwork.
Where are the form submissions stored?
All client responses are saved directly to your Google account connected to the form, allowing you to review them securely in Google Sheets or export them as needed.
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.