Intake Forms
Treatment by Intern – Informed Consent

This form can be used to give clients informed consent when treatment is being provided by an intern. (0421)

Couples Therapy Intake Form

This form can be used as a model for obtaining intake information when treating couples. (0720)

Coaching Intake Checklist

This form helps coaches set the stage for a productive relationship with clients.

Telehealth Emergency Plan

This Emergency Plan provides the therapist with information about who to contact if an emergency occurs during a telehealth session. (0620)

Child Intake Form

This form can be used as a model for obtaining intake information when treating children.

Sliding Scale Fee Agreement

This form can be modified to state a therapist’s sliding scale schedule and to obtain a signed agreement regarding the terms of a reduced fee.

Developmental History Form

This form is intended to obtain a comprehensive history on young clients. (0620)

Life History Questionnaire

This questionnaire covers a wide range of issue that would be useful as a starting point in therapy, including a checklist of problems, information about family background, health issues, and so on. Type: PDF (1014)

Initial Session Solution-Focused Questions

This worksheet can be used as a guide for therapists to ask solution-focused questions during the early sessions of therapy. The questions are designed to stimulate the growth process of clients from their very first encounter with a therapist.

Couples Therapy Agreement

This form is designed to be given to couples at the beginning of couples therapy. It is intended to orient individuals to the basic purpose of couples therapy.