
Comprehensive Client Information
Collects personal, medical, and psychological history for effective counseling.
Free template
A Counseling Intake Form is a crucial document used by mental health professionals to gather essential information about a new client before starting therapy. This form typically includes personal details, medical history, psychological concerns, emergency contacts, and consent for treatment. By completing this form, therapists can better understand the client’s background and…


Collects personal, medical, and psychological history for effective counseling.

Helps therapists create customized therapy plans based on client needs.

Includes consent to treatment and confidentiality agreements.

Greater Cost Savings Compared to Legacy Vendors

Next Generation AI Capabilities

10-day Proof of Concept

Tailored for Security Conscious Enterprises
Trusted by enterprises worldwide





















A Counseling Intake Form typically includes personal details, contact information, medical and mental health history, current psychological concerns, and consent for treatment.
Yes, all information provided in a Counseling Intake Form is confidential and protected under privacy laws, except in cases where disclosure is required by law (e.g., harm to self or others).
This form helps therapists assess a client’s mental health history, identify treatment goals, and ensure ethical and legal compliance before beginning counseling sessions.
Yes, you can update your information by notifying your therapist of any changes in personal details, health conditions, or treatment preferences.
Turn this template into a compliant, e-signable workflow inside Certinal eSign.
Schedule a demo