New Patient Intake Form

Form Template

The New Counseling Patient Intake Form mobile app provides an electronic client intake form for counselors and therapists.

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Language: English
Country: United States of America

Instead of filling out an intake assessment by hand at the beginning of a therapy session or counseling appointment, new patients can complete the form electronically using a smartphone or tablet.

Before beginning mental health counseling services, it's important to understand a patient's previous mental health history and their background. Designed for counseling centers, mental health care clinics, family counseling professionals and independent therapists, the New Counseling Patient Intake Form app makes it easy to gather important patient details either when the patient calls to schedule an appointment or prior to beginning of the session. The user friendly form is a helpful case management tool and can help counselors and therapists tailor their therapy sessions and properly coordinate care to meet the specific needs and background of the patient. The information is saved electronically so that intake coordinators and psychological services providers can quickly access them at any time during treatment.

  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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  • iPhone
  • iPad
  • Android
  • Windows
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  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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