"I was so depressed,

I couldn't get out of bed"

"I needed to find a local psychotherapist quickly"

"I felt so hopeless

and alone"

  "I knew I was addicted and needed help"

 "I was looking for a licensed counselor

who is LGBTQ Friendly"

"My anxiety was out of control"

 "...I needed a therapist who specializes in

child psychology" 

 "My child's teacher asked me to get

an ADD/ADHD Evaluation"

"...my marriage was falling apart

       "I wanted to make sure my counselor had the same Christian values..."

"I am so happy to find a counseling directory so I can find the right therapist."


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Child and Family Counseling Icon
Teen Counseling Small Icon
Small Marriage Counseling Icon
Small Addiction Icon
Evaluations and Assessments Small Icon

LGBTQ Friendly Small Icon
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Free Sample Template Forms for Counseling, Psychology, Mental Health Private Practices


Free Sample Template Intake Forms for Counseling, Psychology, Mental Health Private Practices


Here is a list of commonly used intake forms for counselors and therapists.  You are free to download these forms and edit them as you wish. All forms are in .docx and .doc format for easy editing.  Click on the links to download.


The Sample Child Intake Form for parents to fill out when bringing a child to therapy.





The Sample Adult Self Report Form for adult patients to fill out, explaining the reasons they seek therapy and their history of counseling.





The Sample Patient-Clinician Agreement Form/Financial Responsibility Form for the patient (or gaurdian of patient if underage) to understand what counseling entails and their responsibility in paying for treatment.





When starting a private practice, it is neccesary to have all the forms you need to run your counseling practice effectively.  We have included several of the most important forms for your use.  You may alter the forms as needed to suit your counseling private practice needs.  Some of the most popular forms for a psychotherapy private practice are the Adult Self Report Form, the Child Intake Form, the Patient-Clinician Agreement and the Financial Responsibility Form