Psychotherapy Intake Form

A downloadable Psychotherapy Intake Form used to streamline the intake process for clients receiving psychotherapy services.

By Bernard Ramirez on Jun 20, 2024.

Fact Checked by RJ Gumban.

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Psychotherapy Intake Form PDF Example
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What is a Psychotherapy Intake Form?

A is a tool mental health professionals use to gather important information about a client before beginning therapy sessions. It is typically the first step in the therapy process and allows the therapist to get to know the client, understand their mental health concerns, and develop an effective treatment plan.

The intake form covers many topics, including the client's personal information, medical history, mental health history, current symptoms, and any medications or supplements they take. It may also ask about family history, social support, and previous therapy experiences. By gathering this information, the therapist can better understand the client's mental health, assess any risks or concerns, and tailor their approach to best support client needs.

The intake form also serves as a legal document that outlines the client's rights and responsibilities and the therapist's policies and procedures. It may include information on confidentiality, informed consent, and payment and cancellation policies.

Completing a psychotherapy intake form can also be a valuable experience for the client, as it allows them to reflect on their mental health concerns and goals for therapy. It can also help establish a sense of trust and rapport with the therapist, as the client can share their story and feel heard.

Overall, a psychotherapy intake form is crucial for mental health professionals and clients. It provides a foundation for effective therapy and helps ensure a safe and successful therapeutic relationship.

Printable Psychotherapy Intake Form

Download this Psychotherapy Intake Form to streamline the intake process.

How does it work?

Here are the steps involved in using/filling out a psychotherapy intake form template:

Provide basic information: 

The intake form will typically start by asking for the client's basic information, such as their name, address, phone number, and email address.

Answer questions about medical history: 

The client will then be asked to provide information about their medical history, including any conditions they have been diagnosed with, medications they are taking, and any surgeries or hospitalizations.

Provide mental health history: 

The client will be asked about their mental health history, including any previous diagnoses, medications, or therapy they have received. They may also be asked about any traumatic experiences they have had or stressful life events.

Share current symptoms: 

The client will be asked to describe their current symptoms, including when they started, how often they occur, and how severe they are.

Discuss goals for therapy: 

The client will be asked to share their goals for therapy and what they hope to achieve by working with the therapist.

Sign the consent form: 

The intake form will typically include a consent form that outlines the therapist's policies and procedures and the client's rights and responsibilities. The client will need to read and sign this form before starting therapy.

Submit the form: 

Once the client has completed the intake form, they will typically need to submit it to the therapist before their first session. This can be done electronically or by bringing a printed copy to the first appointment.

Psychotherapy Intake Form example (sample)

This is just one example of what a psychotherapy intake form might look like. The specific questions and format can vary depending on the therapist's preferences and the client's needs.

Download this Psychotherapy Intake Form Example (Sample) here:

Psychotherapy Intake Form example (sample)

When would you use this Template?

Mental health professionals use psychotherapy intake forms as an essential tool for beginning the therapy process. Here are some scenarios where a therapist may use this template:

New clients: 

When a therapist starts working with a new client, they will typically have them complete an intake form. This helps the therapist understand the client's background, symptoms, and goals for therapy.

Return clients: 

Even if a therapist has worked with a client before, they may ask them to complete an updated intake form if they have had any significant changes in their life or mental health.


When a therapist receives a referral from another healthcare professional, they may ask the new client to complete an intake form. This helps ensure the therapist has all the necessary information to provide the most effective treatment.

Legal requirements: 

In some cases, for insurance purposes, therapists may be required to have a completed intake form on file for each client they see.


In emergencies, such as when a client is experiencing severe symptoms or thoughts of self-harm, a therapist may ask them to complete an abbreviated intake form to gather important information quickly.


Using a psychotherapy intake form template can provide several benefits to both the therapist and the client. Here are some of the key advantages:

Comprehensive information gathering: 

By using a standardized intake form, therapists can ensure that they collect all the necessary information about the client's mental health history, symptoms, and goals for therapy.


Intake forms can save time during the first session, as the therapist already understands the client's background and can focus on developing a treatment plan.

Increased client engagement: 

Completing an intake form can help clients feel more engaged in their treatment and give them a sense of ownership over their mental health journey.

Improved treatment outcomes: 

By thoroughly understanding the client's mental health history and symptoms, therapists can develop more targeted and effective treatment plans.

Legal protection: 

A completed intake form on file can legally protect therapists in case of any treatment-related issues.


By using the same intake form for each client, therapists can ensure they collect the same information for every client and maintain a consistent treatment approach.

Research & Evidence

The use of psychotherapy intake forms has become a standard practice in the mental health field, and a significant amount of research and evidence supports its effectiveness.

Psychotherapy intake forms have been used since the 1970s when mental health professionals began to recognize the importance of gathering comprehensive information about a client's background, symptoms, and goals for therapy. Over time, intake forms have become increasingly standardized, with many therapists using similar templates to gather client information.

Research has shown that using psychotherapy intake forms can have several benefits. For example, a 2017 study published in the Journal of Mental Health Counseling found that clients who completed an intake form reported higher satisfaction levels with their therapy sessions than those who did not. The study also found that therapists who used intake forms were more likely to provide evidence-based treatments and had better treatment outcomes.

Another study published in the Journal of Clinical Psychology in 2010 found that therapists who used standardized intake forms were more likely to gather comprehensive information about their clients' mental health history and symptoms. This, in turn, led to more targeted and effective treatment plans.

Why use Carepatron as your Psychotherapy Intake Form app?

For mental health practitioners looking for a productive and practical approach to handling their psychotherapy intake forms, Carepatron is an excellent choice. With a user-friendly UI and complete HIPAA compliance, it is made to be simple to use. It provides a selection of editable templates from which therapists can choose to design intake forms suited to their requirements and preferences.

Carepatron automates time-consuming procedures like sending follow-up emails and appointment reminders, enabling therapists and other healthcare providers to interact. It also offers a comprehensive client management system that allows therapists to manage appointments, treatment plans, and progress notes in one place.

Clinical Documentation Software


Beutler, L. E., Malik, M., Alimohamed, S., Harwood, T. M., Talebi, H., Noble, S., & Wong, E. (2004). Therapist variables. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 227-306). Wiley.

Haynes, S. N., Smith, G. T., & Hunsley, J. D. (2011). Introduction to the evidence-based practice of psychology. Oxford University Press.

Hunsley, J. D., & Mash, E. J. (2007). Evidence-based assessment. Annual review of clinical psychology, 3, 29-51.

McLeod, B. D., Southam-Gerow, M. A., Jensen-Doss, A., Kendall, P. C., & Weisz, J. R. (2016). Benchmarking treatment adherence and competence in individual cognitive-behavioral therapy for youth anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 45(1), 4-17.

The Society of Clinical Psychology (2019). Clinical Practice Guideline for the Treatment of PTSD in Adults. Retrieved from

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.

Why do therapists use intake forms?
Why do therapists use intake forms?

Commonly asked questions

Why do therapists use intake forms?

Therapists use intake forms to gather important client information before the first session. This helps them understand the client's needs and concerns and can inform the course of treatment.

Is it mandatory to fill out a psychotherapy intake form?

While it may not be mandatory, many therapists require clients to fill out an intake form before the first session. This ensures that the therapist has all the necessary information to provide effective treatment.

What kind of information is typically included in a psychotherapy intake form?

A psychotherapy intake form typically includes personal and medical history, mental health history, current symptoms, and goals for therapy. It may also include information about the therapist's policies and procedures and the client's rights and responsibilities.

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