Therapist practice · Updated 2026-10-19

What to include in a therapy intake form (with checklist)

What to include in a therapy intake form: a checklist with client information, background questionnaire and practice policies pages from The Calm Practice Client Forms — The Calm Practice: Client Forms, 16 fillable PDF and Word forms for therapists. See it on Etsy · Buy on Payhip.

Checklist plus real examples: every page shown in this guide comes from The Calm Practice: Client Forms, 16 fillable PDF and Word forms for therapists and counsellors, UK/AU and US editions. Prefer direct checkout? Buy on Payhip.

A good intake form does two jobs at once. It gives you what you need before a first session, and it shows a nervous new client how you work: what you will ask, what you will keep private, and what happens if they cancel. A form that asks for too much feels like a hospital admission. A form that asks for too little leaves you scrambling for an emergency contact at the worst possible moment.

This guide walks through what to include, section by section, with a checklist you can copy, notes on what changes between the UK, Australia and the US, and real pages from our own forms so you can see how each part looks on paper.

What an intake form is for (and what it isn't)

Most private practices use the word "intake" for a small pack rather than one form. In practice it usually covers four things: notes from the first enquiry call, the client's details, a background questionnaire, and a policies agreement they sign. Some therapists add separate consent forms for online sessions or email contact.

The intake form is not an assessment. It gives you a starting picture, not a formulation, and it should never be the only place a client is asked about risk. Many clients write very little and say much more in the room. That's fine. A gentle line such as "Answer as much or as little as you like; we can talk through anything you leave blank" makes it more likely they'll fill it in honestly.

Therapy intake paperwork in order: first call notes, client information form, background questionnaire and practice policies agreement, from The Calm Practice Client Forms — Four pages most private practices use before a first session, in the order a new client meets them.

The therapy intake form checklist

Use this as a starting point and cut anything you won't actually use. Every question you ask is information you then have to store safely.

Client details

Full name and the name they like to be called
Date of birth and pronouns
Address, phone and email
Preferred contact method
Permission to leave voicemails and send reminders
Emergency contact, and when you'd use it
GP or primary care physician, with a yes or no to contact

Background

What they would like help with, in their words
When it started and why they're seeking help now
Previous therapy, and what helped
Other current mental health support
Medication and physical health
Sleep, appetite, energy, concentration
Alcohol and other substances
Relationships, work, living situation
Significant life events
Strengths and what helps

Safety

One clear, direct question about thoughts of self-harm or suicide
What happens if they answer yes
Local emergency numbers on the same page

Agreement

Session length and frequency
Fees, payment and fee reviews
Cancellation and missed sessions
Limits of confidentiality
Supervision
Contact between sessions
Records and how long you keep them
Ending therapy
How to raise a concern
Signatures and dates

1. Contact details and contact consent

The basics are obvious: name, date of birth, address, phone, email. Three small additions make a real difference.

The name they like to be called. Put it next to the legal name, then use it from your very first reply. It costs nothing and it tells the client you were paying attention.

Permission to contact them. Ask separately whether it's OK to leave a voicemail that mentions your practice, and whether you can send reminders by text or email. People share phones, laptops and inboxes with partners, parents and employers. A yes or no tick box settles it before it becomes a problem.

Emergency contact and GP. Ask for both, but say exactly when you would use them. "Someone we can contact if we are seriously worried about your safety. We would only use this in an emergency" is clearer than a bare "Next of kin" line. Ask for consent to contact the GP (or primary care physician in the US) as its own yes or no question, so it's an informed choice and not buried in the small print.

Annotated therapy intake form: client information page showing preferred name, voicemail and reminder consent, emergency contact and GP consent — Four small details on the client information page that prevent awkward moments later.

2. The background questionnaire

This is where intake forms tend to swell. Keep it to questions that change how you'll start working with someone. A two-page questionnaire is plenty for most talking therapy practices.

What brings them, in their own words. Give them a large box. Their phrasing is often more useful than any checkbox list of symptoms.
Timing. "When did this start?" and "What prompted you to look for support now?" are two different questions, and the second often tells you more.
Previous therapy. Ask what was helpful or unhelpful, not just whether they had it. Also ask if they're currently seeing another mental health professional.
Health. Current medication (name, dose, what it's for) and any physical conditions you should know about. A short rating row for sleep, appetite, energy and concentration takes seconds to fill in and gives you a quick baseline.
Alcohol and other substances. Use frequency options rather than an open question. People answer "2 to 3 times a week" more readily than "Describe your drinking."
Their life. Who is around them, work or study, living situation, and significant losses or changes.
Strengths. "What helps you get through hard times?" balances a form that is otherwise all about problems, and it gives you something to build on in session one.

If you use outcome measures such as the PHQ-9, GAD-7 or CORE-10, keep them as separate sheets. They're scored and repeated over time, so they belong with your progress reviews rather than inside the intake form.

3. Asking about risk on a form

Some therapists leave risk off the intake form entirely and ask only in person. Others ask one direct question. If you include it, three things matter.

Normalise it. "We ask everyone this question" tells the client they haven't been singled out.
Ask it plainly. "Are you currently having thoughts of harming yourself or ending your life?" with Yes and No. Vague wording gets vague answers.
Say what happens next. Explain that you'll talk it through at the first session, and give local emergency numbers right there on the page for anyone in immediate danger.

Then make sure you actually read forms before the session. A "yes" sitting unread in your inbox for three days is worse than not asking. If you can't promise to review forms in advance, say so on the form and ask the question in person instead.

Close-up of a therapy intake questionnaire with a strengths question and a direct safety question, with Yes and No boxes and what happens next — The strengths question comes first, then one plain safety question with a note on what happens next.

4. Practice policies and agreement

This is the page that saves the most awkward conversations later. Write it in plain language, in the first person if that suits you, and cover:

Sessions: length, usual frequency, and how often you review progress together.
Fees: the amount, how and when to pay, and how much notice you give before a fee change.
Cancellations: your notice period (24 or 48 hours is common) and what you charge for late cancellations or missed sessions.
Confidentiality and its limits: serious risk of harm to the client or others, legal or court requirements, and safeguarding children or vulnerable adults. Add that, where possible, you'll talk to them first.
Supervision: that you discuss your work with a clinical supervisor without sharing their name or identifying details.
Contact between sessions: what it's for (booking and changes), how quickly you reply, and that messages aren't monitored for emergencies.
Records: what you write down, where it's stored, how long you keep it, and that clients can ask to see it.
Ending: that they can stop at any time, that you'll try to plan a final session together, and what you do if they stop replying.
Concerns: how to raise a concern with you, and the professional body they can contact if that doesn't resolve it.

Finish with a short statement ("I have read and understood this agreement and have had the chance to ask questions") and signature and date lines for both of you. Use templates as a starting point only: check the wording against your professional body's guidance before you use it.

Separate consents worth having

If you offer online sessions, a short online sessions agreement covers the platform, a private space, what happens if the connection drops, and where the client is during the session. A separate consent to email and text contact records the risks of unencrypted messages. If you ever need to speak to a GP, psychiatrist or another professional, use a written authorisation to share information (a "release of information" in the US) that names who, what and for how long.

5. What to leave out

Anything you won't use. If you never look at a client's religion, income or full family tree, don't ask for it. Under data protection law, collecting only what you need is the rule, not a nice extra.
Long symptom checklists. Forty tick boxes can feel like being diagnosed by a form. A few open questions do more.
Legal claims you can't stand behind. Avoid words like "fully compliant" unless a qualified adviser has reviewed your paperwork for your situation.
Payment card numbers. Don't collect card details on a PDF or Word form. Use your payment provider or practice software.

6. UK, Australia and US: what changes

The structure of a good intake pack is the same everywhere. The details are not.

	UK	Australia	US
Privacy law	UK GDPR and the Data Protection Act 2018. Health data is special category data.	Privacy Act 1988 and the Australian Privacy Principles, which cover health service providers of any size.	HIPAA for covered providers, plus state law.
Doctor	GP	GP	Primary care physician
Dates	DD/MM/YYYY	DD/MM/YYYY	MM/DD/YYYY
Emergency	999, Samaritans 116 123, NHS 111	000, Lifeline 13 11 14	911, 988 Suicide & Crisis Lifeline
Extra paperwork	Most practitioners also pay the ICO data protection fee.	A clear privacy collection notice.	A Notice of Privacy Practices if you're a covered provider, a Good Faith Estimate for self-pay clients, and superbill details if clients claim out of network.

Check the current rules with your regulator or professional body. Things like the ICO fee, Good Faith Estimate requirements and crisis line numbers do change, and your intake pack should change with them.

Therapy client support plan crisis numbers in two editions: UK 999, Samaritans 116 123 and NHS 111, Australia 000 and Lifeline 13 11 14, and US 911 and 988 — Crisis numbers checked for each country, in the UK/AU and US editions of the support plan.

7. PDF, Word or practice software?

Practice management software handles intake well if you already pay for it. If you don't, a fillable PDF is the simplest option for clients: it opens on any phone or laptop, it looks the same everywhere, and it prints cleanly for anyone who prefers paper. An editable Word version is useful for you, because you'll want to adjust the wording of your agreement over time.

Whatever you use, think about how the completed form comes back. A filled PDF sent as an ordinary email attachment is convenient but not private. Many therapists ask clients to upload forms through a secure portal or encrypted email, or to bring them to the first session.

A therapy client information form filled in as a fillable PDF beside a practice policies agreement open as an editable Word document — Fillable PDF for clients, editable Word for you.

8. When to send it

Send intake forms when the first session is booked, and ask for them back a day or two before. That gives you time to read them properly, especially the safety question. Tell clients how long it takes (about 15 minutes for a two-page questionnaire), and that it's fine to leave questions blank. For clients who find forms hard, offer to go through it together at the start of the first session instead.

Want this pack ready to use? The Calm Practice: Client Forms has 16 fillable forms that follow this guide, from first call notes and client information to the background questionnaire, policies agreement, DAP and SOAP notes, support plan and ending summary. Each comes as a fillable PDF and an editable Word file, in a UK/AU edition (A4) and a US edition (Letter).
See it on Etsy Prefer direct checkout? Buy on Payhip.

Overview of 16 therapist intake and practice forms, from enquiry call notes to an ending therapy summary, in The Calm Practice Client Forms — All 16 forms in The Calm Practice: Client Forms.

FAQ

What should be included in a therapy intake form?

At minimum: contact details and contact preferences, an emergency contact, GP or primary care details with consent to contact, the reason the client is seeking therapy, previous therapy, current medication and health, alcohol and substance use, important life circumstances, one clear safety question, and a signed agreement covering fees, cancellations, confidentiality limits and records.

How long should a therapy intake form be?

For most private practices, one page of client details and a two-page background questionnaire is enough, plus a one-page agreement. If a client needs more than about 15 to 20 minutes to complete it, you're probably asking for things that are easier to explore in session.

Should I ask about suicide on an intake form?

Many therapists do, with one direct question, a sentence saying that everyone is asked, and local emergency numbers on the same page. Only include it if you will read forms before the first session. Either way, risk should also be explored in person.

Is an intake form the same as an informed consent form?

Not quite. The intake form collects information about the client. The policies agreement, or informed consent, explains how you work and what they're agreeing to: fees, cancellations, confidentiality and its limits, records and ending. Many therapists send them together as one intake pack.

Can I use an intake form template?

Yes, as a starting point. Edit the wording so it matches how you actually work, then check it against your professional body's guidance and the privacy law where you practise. A template is not legal advice.

This article is general information for therapists and counsellors in private practice, not legal, clinical or ethical advice. Follow your professional body, regulator and local privacy law. Related reading: SOAP vs DAP notes, with examples · what therapists can post on social media · therapist link-in-bio page · therapist Instagram bio · The Calm Practice Instagram kit.