How to write an intake form for any practice

To write an intake form, open with contact details and how the client wants to be contacted, then ask why they have come in their own words, then the history and screening questions that could change the treatment, then the consent and the fees, and finish with a signature where one is needed. Explain each sensitive question in a sentence before it appears, give a way to raise it in person instead, and decide before you publish who reads the answers and where they arrive. The same order works for a counsellor, a physiotherapist, a dentist or a vet; only the middle section changes.

Intake is not an application

An application decides whether someone gets something. An intake form is filled in after that decision, by somebody who has already booked, and its only job is to make the first appointment safe and well used. The physiotherapy intake form for a fictional Brunswick clinic says it outright in its intro: the physiotherapist reads the form beforehand, which buys back about ten minutes of the session for treatment.

That difference changes how you write. An application has to be neutral because answers are judged. An intake form can be warm, can say why it is asking, and can let a client leave a written answer short and explain it in the room. The psychology intake form titles its welcome screen “Twenty questions, and you can stop at any of them”, which would be an odd thing for an application to say and exactly the right thing for an intake form.

The sections

Most intake forms have five sections, and the order matters more than the count.

About you, with contact permissions. Name, date of birth, contact details and an emergency contact. The therapy intake form folds a permission into two of its labels: “Mobile, and whether we may leave a voicemail” and “Email, and whether we may email you”. For a client who shares a house or an inbox, that permission is part of the contact detail, not an extra.

Why you are here. An open question in the client’s own words, then one about the goal. The therapy form asks what brings the client to counselling now and what they would like to be different in three months.

History and screening. The questions that change what the practitioner does. A rating grid is efficient here: the therapy form asks how often, over the last two weeks, the client has felt down, lost interest, felt on edge, slept badly or struggled to concentrate, all on one shared scale.

Consent and fees. A paragraph that says what the client is agreeing to, then the tick.

Signature. Where the practice needs one, at the end.

The massage therapy intake form shows how the middle section changes with the practice. It spends its effort on two questions a client finds easier to answer on a form than face down on a table: how much pressure, and which areas to leave alone.

Sensitive questions

The OAIC’s guide for health service providers says health information can be collected with the patient’s consent when it is reasonably necessary for your activities, and generally only directly from the patient. Reasonably necessary is the test to apply to each clinical question. If the practitioner will not read it before the first appointment, it probably does not belong on the form.

Sensitive questions also have a measurement problem. People soften answers they think will be judged, which is social desirability bias, and an intake form cannot be anonymous. What it can do is lower the stakes of an honest answer. The therapy form’s safety question is preceded by three short sentences in a paragraph: everyone is asked this, a yes means the therapist will raise it gently in the first session, and if help is needed now, call Lifeline on 13 11 14 or 000. The question then offers three answers: no, yes, and prefer to discuss in session. The third answer is what makes the other two believable.

Two smaller habits help. Use bounded lists for conditions, with a none option, so a client ticks rather than writes. And ask about other people only where it is clinically used. The OAIC guide allows a practitioner to collect information about another person from a patient when it is part of the patient’s family, social or medical history and necessary to provide the service, but the permission is tied to that purpose.

Consent inside the intake

Consent on an intake form is two things that are easy to blur: consent to how the information is handled, and consent to the service itself.

For the information, APP 5 says reasonable steps to notify must be taken at or before the time of collection, and for a form it suggests clearly and prominently displaying the notice matters in the form or giving a prominent link to the notice. The OAIC also accepts layered notices, a short one on the form backed by a longer policy. So the notice belongs on the form, near the top, not in an email afterwards.

For the service, the Australian Commission on Safety and Quality in Health Care describes informed consent as agreement given voluntarily after accessible, accurate and relevant information about the benefits, risks and alternatives. On a form, that means the client reads the terms before the tick. The therapy form’s consent paragraph gives the session length and fee, the cancellation charge, and the limits of confidentiality in one plain sentence, where there is a serious risk to the client or someone else or the law requires disclosure, directly above “I have read the above and consent to counselling”.

The patient intake requirements post goes through the privacy principles and the access settings in detail, so they are not repeated here.

After submission

Decide three things before the first client sees the form.

What the client sees. The psychology form’s thank-you screen repeats Lifeline and 000, and says the practice is not a crisis service and messages are checked in business hours. That is the right place for it, because it is the last thing read.

Where the answers go. Responses sit in the responses table, and each one can be downloaded as a PDF for the client file. Uploaded imaging reports and referral letters are appended to that PDF as extra pages. Be careful with the email alerts add-on: it sends each submission to one address with the answers written into the message, which puts clinical details in an inbox. A webhook posts the full response once, with no retry, so the receiving system has to be ready.

Who reads it and when. Most of the health examples here tell the client the practitioner reads the form before the appointment, and the chiropractic form’s thank-you screen adds that no adjustment happens until the findings are explained and agreed. Only promise what the practice actually does.

Intake forms by practice

The table at the end of this article compares seven intake examples from different practices: the sections each uses and the fields that need the most careful handling. Read across a row to see how a practice turns the five sections into its own form. The veterinary row is a useful outlier: the client is the owner, and the sensitive field is a second person authorised to make decisions about the animal.

Common mistakes

Clinical questions first. A list of conditions on the first screen, before the form has said who is asking, is how a client closes the tab.

A yes or no safety question. Two answers make honesty expensive. Add a way to discuss it in person.

Helper text in a field description. On a published classic form, descriptions only show for file upload and photo fields. Put the explanation in a paragraph above the question.

Everything required. The therapy form requires contact details, the referral, the safety question and consent, and leaves the reflective questions optional. That is a choice worth copying.

Clinical answers in an email alert. Read them where you control access.

Build it

The embedded example is a classic form, and it has to be, because it ends with an inline signature and inline signing does not work on a published conversational form. If your intake needs a signature or a photo of a health fund card, build it as classic with paragraph blocks, short and long text, radio buttons, checkboxes, a rating matrix, a date picker and inline signing, plus file upload for referral letters.

If the intake is a questionnaire before the first visit, with no signature, a conversational form fits well: one question per screen, a description printed under each question, and file upload still works. The conversational form builder page shows the format, and the tutorial on creating a conversational form with AI covers generating a first draft and editing each question. Whichever you choose, set the access type before publishing: public, secret key, login required or domain restricted.