Intake Assessment

How Does this Intake Assessment Work?

Step One. Fill Out the Template

First, search for “intake assessment” on Carepatron’s template library on the website or within the desktop, iOs, or Android app. Fill out the template digitally on Carepatron or using your PDF editor. More comfortable with pen and paper? Then, download and print a copy instead.

Begin filling out basic demographic information such as the patient’s name, age, gender, race, contact number, etc., before moving forward with the next step.

Step Two. Ask for Consent

Since you will be asking sensitive questions and writing confidential information, before anything, ask for the patient’s consent in the beginning and, if possible, throughout your assessment.

During this step, you may also ask them to sign the template at the bottom for written proof of consent.

Step Three. Make an Assessment

Once your patient has given their verbal and written consent, proceed with your intake assessment. With our comprehensive template, you’ll know the reason for your session and gather the relevant information needed.

Step Four. Review Notes

Though our template contains closed questions and checklists, there are categories with open-ended questions. It’ll be helpful to go over the answers for polishing or in case you want to make additional notes and observations.

Step Five. Organize and Secure

Once finished with the first four steps, organize and secure your work. Place physical copies in a folder or drawer solely for the client at a location with security measures set in place.
For digital copies, store them on Carepatron. Our software has tags for organizational purposes and is a HIPAA-compliant, safeguarded online EHR platform. Take your security to the next level by limiting viewing access to involved parties only.

When to Use an Intake Assessment PDF?

An intake assessment is similar to a clinical interview but with the following primary purposes:

• To know the reasoning behind the first session
• To gather information, especially ones related to or affecting a patient’s mental health such as psychiatric history, medical history, family background, occupation, and more.
• To build a trusting relationship between you and your patient.

Given these purposes, an intake interview template’s notable difference is its less comprehensive nature. Therefore, before you download and edit a PDF copy of our intake assessment template, consider using the document only when:

• You’re meeting with a new client or need to update outdated information of a returning client.
• You need guidance with the questions you must ask, a suggestion of how to conduct the assessment or an idea of what factors to consider when making a clinical impression or diagnosis.
• You need a new or an additional record of the patient’s history focused on their mental health, which you, fellow mental health practitioners, or third parties can use as a reference.

Who is this Printable Intake Assessment for?

Any mental health care professional who conducts counseling or therapy sessions may benefit from the printable intake assessment template. More specifically, the following practitioners can make the most out of our template:

• Psychologists
• Counselors
• Clinicians
• Therapists
• Clinical social workers
• Psychiatrists
• Psychiatric or mental health nurse practitioners

These professionals can find that using the template in the following settings is helpful:

• Hospital
• Rehab or in-patient mental health centers
• Rooms, offices, or establishments where professionals conduct psychological and psychiatry or psychotherapy

However, if the patient is unable to make a physical appearance, you may also conduct the interview via a video call or send the form via e-mail on Carepatron.

Benefits of Free Intake Assessment Questions

Customizable

Practitioners know that one size doesn’t fit all. And what better way to start a patient’s personalized treatment than with a customized template? As the expert and practitioner in charge, it’s your call on which questions will help you with your clinical impression or diagnosis.

Therefore, we’ve made our template customizable via a PDF editor on our software platform so you can edit the template to reflect better the content and flow of the scheduled session you will conduct.

Comprehensive

Our free intake assessment template is a complete document that covers most of the basics and considers the various factors that may affect a patient’s mental health. It consists of questions, from the reason for the appointment to details on areas of your life.

Personalized Treatment

Every patient is different, and based on their answers, their treatment approach will vary. With the help of the intake assessment questions on our template, you can best decide the next practical step moving forward.

Early Detection

With a comprehensive free intake assessment template, you can more likely identify and pinpoint what troubles the patient. This will result in both early detection and intervention to prevent the worsening of symptoms.

Reliable

Compared to a general questionnaire or a one-page Q&A form, our intake assessment template can be used as a reliable resource because of its content. After all, documents such as these need to be detailed and as accurate as possible to prevent misdiagnosis or mistreatment.