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Templates Counseling Intake Form Template

Counseling Intake Form Template

Help patients gain access to therapy quicker and easier with this digital mental health intake form.

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Help patients gain access to mental healthcare faster and more efficiently with this customizable counseling intake form. New patients can use their phone to provide basic information, emergency contacts, and medical history without filling out endless paperwork. Route the data back to your providers or EHR for easy follow-up and storage.

Stay HIPAA compliant.

Stay HIPAA compliant.

Keep sensitive medical information safe and secure with our HIPAA compliant solution. Have confidence knowing information can be conveniently collected and shared while still maintaining compliance through data encryption, safe storage, and key healthcare integrations with Formstack.

Safely and securely share medical files.

Safely and securely share medical files.

No more file folders or cabinets. With this mental health intake form template, you can use one form to transmit all your patient information to save time, minimize errors, and house important data in a single place. Whether you’re gathering mental health evaluations or prescriptions, data is handled safely and securely in one platform.

Increase front office efficiency.

Increase front office efficiency.

Keep your team organized and productive by working smarter, not harder. After completion, send counseling intake forms to the right people for review and follow-up through automated workflows. Then, allow practitioners to enter their notes and comments on a single form with ease.

Adapt to different referral types.

Adapt to different referral types.

Use Conditional Logic to create a single form that has the ability to refer patients to a number of different providers or therapy types. The counseling intake form template will auto-populate based on the referral type you select, even allowing you to choose multiple specialists and prefill the form with their information.

Social Proof

"Formstack's intuitive interface helps us build and modify a variety of medical forms used daily in our practice. We use Formstack to collect new patient data and route patient communication forms to medical assistants, the front office, billing, and administration. This design flexibility and the ability to create customized notifications saves us an incredible amount of time and money."

Dr. Chris Bojrab
President at Indiana Health Group

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