Psychotherapy Intake Form 

What is a psychotherapy intake form?

A psychotherapy intake form is a document that is used by a psychotherapist to assess the mental health of a patient, including their health conditions and needs. It records the patient’s health history, symptoms, medications, and goals for therapy. A psychotherapy intake form is filled out by the patient initially and then is completed by a psychotherapist to record diagnosis and treatment. 

What details must be included in a psychotherapy intake form?

A psychotherapy form includes the following details:

• Patient’s medical and personal information
• Mental health history 
• Current symptoms and challenges
• Goals for therapy
• Additional information
• Patient’s consent 

Are there any legal requirements pertaining to the psychotherapy intake form?

A psychotherapy form is legally bound as it highlights the rights of the patient and the responsibility of the psychotherapist. The form must be accurate and clear, and the therapist must comply with HIPAA’s guidelines to avoid any legal disputes. Failure with respect to the collection of information and its maintenance can result in severe penalties. Whether it is a breach of confidentiality or malpractice, the psychotherapist’s negligence can bring along consequences.  

Who fills out a psychotherapy intake form?

A patient who is seeking therapy is required to fill out this form. Ideally, this form is filled out before the commencement of the first therapy session. This is because the therapist needs to understand the concerns and goals of the patient before starting the therapy. During the first session, the therapist reviews the form and develops the most appropriate course of treatment for the sessions that follow. This form can also be completed by the patient’s caregiver or guardian; either physically or electronically. 

What things should be taken into consideration while creating a psychotherapy intake form? 

Before creating such a form, the therapist must:

• Clearly define the purpose of the form 
• Ensure that the language is straightforward
• Make sure that the form is simple to understand and organised
• Ensure that the form states the confidentiality of the information that is gathered 
• Take the sensitivity of the information into consideration