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Counseling Intake Form Template

Easily send and receive your counseling intake forms online. Send patients your online intake form to fill out on their phone, tablet, or computer. Patients securely sign and submit completed counseling intake forms directly to your account online. Track the progress of new client counseling intake forms, send automated reminders, and receive completed forms online.
Setup a Counseling Intake Form
Counseling Intake Form

Counseling Intake Form Template

Give clients the freedom to complete counseling intake forms with any device, anywhere. Streamline the way you collect signatures and consent forms by setting up your counseling intake form online. 

Easily personalize this counseling intake form template with a HIPAA compliant form builder.

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What is included in the Counseling Intake Form Template?

01Patient Information

Your counseling intake form will require the patient’s information, which will include; the patient’s name, phone number, address, email address, date of birth, social security number, and other identifiable information that is relevant. 

02Health History

Health history will collect important information and give you all you’ll need to correctly assess your patients based on their personal health history, as well as the history of any family members. 

03Questionnaires

Our questionnaire templates make it easy for you to get all the other information you need from your patients regarding specific diagnostic tests. Included in this packet template is a GAD-7 patient questionnaire, a self-administered test that can help identify probable cases of Generalized Anxiety Disorder. Also in the packet is the PHQ-9 patient health questionnaire which will help you assess your patients for possible depression. 

04Privacy Practices and Consent Forms

This Counseling Intake Form Template packet has included a notice of privacy practices as well as an informed consent form. Cover all of your bases in one simple location!

05Mobile-Friendly Forms

Easily build fully-responsive medical forms online that allow your patients to sign and submit on any device, anywhere, at any time.

06Save And Continue Later

Allow patients to save their progress on larger forms and packets. Patients will be able to resume where they left off and finish completing your forms at a later time.

07HIPAA Compliant Electronic Signatures

Collect electronic patient signatures before the appointment. Easily give your patients the ability to digitally sign from their phone, tablet, or computer.

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Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
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Open API and HL7

Automatically send patient data to a designated location in another program. Share data between FormDr and the EMR or other applications used in the practice.

Encrypted PHI

Encrypted PHI ePHI

All PHI is encrypted in transit and at rest—while being submitted back to your account and at rest in our database. Protect sensitive data with fully encrypted patient submissions.

Embed Forms on Website

Embed Forms on Website

Embed your forms directly on your website for a seamless experience for your patients. Your forms are customized with your logo, brand, and styling to match your site. Embed on Wordpress, Wix, Squarespace, and many more.

White Labeled HIPAA Compliant Forms

White Labeled Accounts

Have your account match your company branding with FormDr White Labeled Enterprise. Create a customized, branded look without having to build your own HIPAA compliant online form software.

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They love FormDr - and so do their patients

  • “

    Not having an online custom form to offer patients was a huge struggle. FormDr makes paperwork seamless and saves a ton of time and money by allowing us to upload to patients EMR rather than print, fill out, scan, and then attach. That is now a hindrance of the PAST!

    Woodlands Dermatology
    Angela H.
  • “

    Patients can fill out the forms at their leisure, and don’t have to print anything. We’re collecting more completed forms than ever, and patients love not having to do anything when they come to the office for the first time.

    FYZICAL MetroWest
    Lauren A.
  • “

    FormDr allows me to send and receive attractive, professional forms from patients. Very helpful that I can remind patients of their appointment time and check the status of the form.

    Banks Hepatology Institute PC
    Alpha B.
  • “

    Sending a PDF was too time consuming for the patients to do, and it required the additional steps of printing and scanning it into our own systems. FormDr made it easier to get patients to complete the forms by email, and it’s a more secure way to provide info than simply emailing back a completed PDF.

    Reload Therapy
    Angie I.
  • “

    Before FormDr, the most common struggle were our patients taking a long time to complete forms in our office. Now patients are able to be seen faster when forms are completed prior to visit. Very easy service to create forms online!

    Skin Science Dermatology
    Courtney M.
  • “

    The support is second to none. FormDr has been instrumental in streamlining our intake of new patients.

    Lang Orthodontics
    Eric L.
  • “

    Before, clients weren’t signing our forms before the appointment. FormDr has allowed us to share our documents for client review and signatures. I really appreciate the support, it has been super helpful simplifying our forms!

    Meridian Behavioral Health
    Laura W.

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FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who:

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms