Finding the right counseling intake form template can be frustrating. Many templates available online are either poorly designed, require you to sign up or create an account, or worse, demand payment.
But not anymore! With my free counseling intake form template, you get a high-quality, fully editable form without any strings attached.
This template is available in two versions: a black-and-white version for simplicity and a colored version for a more professional touch.
Both are designed to meet the needs of therapists, counselors, and mental health professionals, ensuring a smooth and efficient intake process.
Why Choose This Template?
- Completely Free: Unlike other platforms that ask you to sign up, create accounts, or even pay for the template, my form is 100% free.
- Fully Editable: The template is completely customizable to match your specific needs. You can edit the fields, add branding, or tweak the format.
- No Hassles: Simply click the “Get This Template” button, then hit “Use Template” to make a copy. Once done, you can print the form as is and fill it out by hand or complete it online and print it.
- Professional Design: The template is clean, well-structured, and organized into easy-to-read sections.
Template Fields
The counseling intake form includes the following sections:
1. Client Information
- Full Name
- Date of Birth (DOB)
- Gender
- Address
- Phone Number
- Email Address
- Emergency Contact Name
- Emergency Contact Phone
2. Background Information
- Occupation
- Marital/Relationship Status
- Current medical care
- Medications
- Past or current mental health concerns
- Previous therapy experience
3. Mental Health Assessment
- Current concerns/symptoms
- Duration of concerns
- Sleep patterns
- Energy levels
- Appetite
- Substance use
4. Session Goals
- Short-term goals
- Long-term goals
5. Informed Consent
Includes terms and conditions such as confidentiality, cancellation policy, payment requirements, and acknowledgment of understanding.
6. Progress Notes (S.O.A.P Format)
- Subjective: Client-reported concerns and feelings
- Objective: Observations and measurable outcomes
- Assessment: Analysis of client’s progress
- Plan: Goals and next steps for treatment
How to Use This Template
- Click “Get This Template”: Start by clicking the button to access the template.
- Select “Use Template”: This will create a copy in your Google Drive.
- Customize or Print: Once you have the template, you can:
- Print it as is and fill it out by hand.
- Fill the form online and then print it.
Free Counseling Intake Form (B&W)
Free Counseling Intake Form (Color)
