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New Client Intake Form

This client intake form improves healthcare outcomes and patient experiences while maintaining HIPAA compliance.

Bernard Ramirez avatar

By Bernard Ramirez on Aug 2, 2025.

Fact Checked by Ericka Pingol.

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New Client Intake Form Template

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Commonly asked questions

While intake forms in healthcare vary by specialization, they generally include personal information (name, date of birth, address, contact details), past medical history (personal and family), current medications or diagnoses, insurance details if applicable, emergency contact information, and required signatures. Other forms of client intake outside healthcare may include client-specific tax details.

The primary purpose of the New Client Intake Form is to gather essential information that will facilitate a more informed care delivery process. A practitioner must have access to relevant data for new clients. This may include any allergies, conditions, or medications the patient has. Knowing whether the patient's family has a history of conditions or diseases is essential so the practitioner can test for predispositions and engage in preventative care.

Insurance information is often included in intake forms so the healthcare practice can pre-validate insurance before the patient's first appointment. As I'm sure you know, the medical billing process is complicated, and validating insurance early helps ensure that reimbursement is timely and claims are valid.

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