Mental Health Intake Form Template

Add this mental health intake form template to your website with 123FormBuilder. Edit the template with simple drag & drop, no coding skills needed.

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About this template

This mental health intake form can be used by all healthcare practices in preparing their patients’ visits by asking them to easily fill in this comprehensive online form in advance. The pre-built template allows you to select from a wide variety of fields covering both mental and physical history, current and past medications, lifestyle and others. You can improve the patients’ experience at your clinic by gathering all needed information in advance, in a secure and compliant manner. To customize this mental health intake form, all you need is our drag-and-drop form builder tool.

Frequently Asked Questions

What is a mental health intake form?

A mental health intake form is used by healthcare professionals for collecting all needed data related to a patient’s personal contact info, medical history and other specific data, while signing up new patients for their practice.

How do I customize this template?

This mental health intake form sample will save your practice a lot of time. It’s already populated with all the necessary form fields, such as a physical and mental history, symptom description, past and current medication and so on. Personalize it to match your needs without worrying about code – you don’t need any technical skills. Just modify the template with the drag and drop tool. Even configuring automatic responses and multiple email recipients are easy to do.

How do I publish a template?

Once your mental health intake form is ready, share it with patients. For instance, you can make it available on a tablet in the waiting room, because it’s also mobile-ready. Or embed the form code in your website – this requires just a copy and paste effort. The form is easy to publish literally anywhere online – web pages, email messages, social platforms.

How can I collect & manage data?

Build your own mental health patient filing system starting with an online form sample. All sensitive patient data will reside in a secure database. Plus, you can add HIPAA compliance to your form with just a few clicks. Update your form entries from our dashboard or download them to your computer as Excel, CSV or PDF. Furthermore, we also integrate with the most popular file management apps and CRM systems.

How can I optimize processes?

123FormBuilder is created to accommodate even non-technical users. So, customize and share your own mental health intake form within minutes. And if you want to take advantage of more advanced features, we’ve got them as well. It’s time to renounce paper forms and start saving huge amounts of time with the help of online forms. Specifically, you will receive an instant alert when a mental patient fills out your intake form.

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