Intake Form Example

There are many factors involved in building a successful private practice. But the single most important factor is seeing clients. Without clients, you don’t have a private practice. This makes it very important to have an efficient intake process!

Having a processes in place shows your professionalism and helps you start developing a therapeutic relationship.

Since your business serves a community, word of mouth will always be your best source for new referrals. So make your first impression a great one with the following tips:

• Have business cards on hand
• Run an easy and accessible website
• Be clear and concise about the services that you provide
• Make sure you can be contacted relatively easily
• and of course, have an effective intake process in place

When you are making your intake process pretend that you are the client. Does your process follow an order that is easy to understand? Can you get through your process in one client session? Are all your questions relevant? These points convey your expertise to your client.

Your intake form should be custom to your business and the type of client you are seeing. Download this month’s free resource the intake form template and modify it to suit your needs. Make sure your form has:

1. Everything you need to open up a new client chart (e.g date or birth, health card number)
2. Relevant Medical History
3. Intake Assessment (depending on the type of work and length of your first session)
4. Legal agreement to begin interventions