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.
- Patient-Clinician Agreement/Financial Responsibility Form (Group Practice) (.doc format)
- Patient-Clinician Agreement/Financial Responsibility Form (Group Practice) (.docx format)
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.