Intake Assessment

Gather patient information and build a therapeutic relationship using our template for intake assessments. Download and edit yours for free!

By Patricia Buenaventura on Apr 08, 2024.

Fact Checked by RJ Gumban.

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What is an Intake Assessment?

An is a medical practitioner’s process to collect information and foster a professional relationship built on trust. This test is commonly used in clinical settings for mental health assessment.

Depending on the practitioner, intake assessments may vary in length and content, affecting the interview/assessment duration. Some practitioners prefer to ask about the mental health status of their patients and the reason for the consultation. Others prefer to be more in-depth, gathering information such as medical and medication history, substance use frequency, family background, educational history, and occupational history. What’s important to note here is that intake assessments are more comprehensive than general health questionnaires, and their purpose is mainly to identify physical and psychological issues.

The information gathered from an intake assessment is primarily used to make a clinical impression, not necessarily a diagnosis. Should the patient be in the middle of a treatment plan, the practitioner may also use the document to affirm or question the effectiveness of the said plan.

Printable Intake Assessment

Download this Intake Assessment to evaluate the health of your clients prior to treatment.

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. 

Intake Assessment Example (Sample)

Here’s an example of an intake assessment you may use as a guide for your unfilled template. Use this sample for noting answers and observations.

Download this Intake Assessment Example (Sample) here:

Intake Assessment Example (Sample)

When to Use an Intake Assessment PDF?

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

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. 

Practice Management Software Feedback

Why Use this Intake Assessment App?

When gathering information and building connections with new patients or even returning patients, focusing on the patient is needed to ensure stellar patient care. However, as practitioners know, there’s more to be done than conducting an assessment, and most of the time, these tasks are the ones that require a practitioner’s time and effort. 

Streamline administrative tasks and processes by automating them with the help of the leading software management platform, Carepatron. Our software has the resources and tools to streamline business processes and clinical documentation. 

On your personalized dashboard, you can access over 100 free PDF templates for any test you have to administer or survey your patients must answer. They are customizable with a PDF editor or on Carepatron. Moreover, you can store your documents on our secure HIPAA-compliant, reliable, and secure EHR, accessible on any gadget anytime and anywhere. 

Other administrative tasks, such as payment and scheduling, are also made easy on our platform. You can automate appointment scheduling, set medical billing and payment procedures in place, and even conduct telehealth visits.

Sign up for Carepatron today for free to get access!

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Why is an Intake Assessment popular?
Why is an Intake Assessment popular?

Commonly asked questions

Why is an Intake Assessment popular?

It is popular because it is the first and essential step to recognising, diagnosing, and treating mental health problems. 

When to use the Intake Assessment?

An intake assessment is best used at the beginning of a session with a new or returning client whose consultation information, medical history, etc., needs to be updated. 

How long do intake assessments take to complete?

It really depends on how comprehensive the customized intake assessment is. However, usually, it takes around one hour (1) to complete. 

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