Contents of the Template:
- Personal Information Section: Records basic details like name, DOB, contact, and emergency contacts.
- Reason for Seeking Therapy: Allows clients to express their reasons for starting therapy.
- Medical History: Covers physical health, past surgeries, medications, and more.
- Psychiatric History: Details any past therapeutic interventions and mental health diagnoses.
- Substance Use History: Helps understand any substance-related concerns.
- Current Symptoms and Concerns: A checklist for clients to rate current issues.
- Relationship History: Provides an overview of the client’s significant relationships and past traumas.
- Goals for Therapy: Encourages clients to express what they aim to achieve.
Why Use This Template:
- Efficiency: Speeds up the initial assessment process.
- Consistency: Ensures all necessary information is consistently collected for every client.
- Client Comfort: Allows clients to prepare and self-reflect before starting therapy.
- Easy Customization: Adaptable to different therapy forms or specific client groups.
- Digital Compatibility: Compatible with Word and Google Docs, making it accessible and easy to share.
Ideal For:
- Private Therapists: Who need a standard intake form for their practice.
- Mental Health Clinics: To streamline the onboarding process for new clients.
- Counseling Centers at Educational Institutions: To better understand and assist students seeking help.
- Teletherapy Platforms: Offering online counseling services and needing digital forms for intake.
- Therapists Transitioning to Private Practice: Who require a thorough intake process for a growing client base.
