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Psychotherapy Assessment Form Mobile App

The Psychotherapy Assessment Form mobile app was created for therapists to make it easy for patients to complete a Psychotherapy Assessment Form using an iPhone, iPad, or Android device. This app can be made HIPAA compliant. You should discuss the use of this app with your patients to gain informed consent before using this mental health assessment and build on your therapeutic relationship.

You can make this comprehensive assessment as specific as necessary to properly assist your patients. You can also use it after each therapy session to track progress and detail mental status after a given amount of time. All progress notes and treatment plans are securely saved in the GoCanvas Cloud and can be emailed or printed as a PDF if you need to share it with family members, other mental health professionals, or social workers.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Psychotherapy Assessment Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name

  • Ico date

    Date

  • Ico multiline

    Address

  • Ico integer

    Age

  • Ico date

    DOB

  • Ico dropdown

    Sex

  • Ico textbox

    Home Phone

  • Ico textbox

    Occupation

  • Ico textbox

    Work Phone

  • Ico integer

    No.

  • Ico textbox

    Marital Status

  • Ico textbox

    Currently living with

  • Ico textbox

    Spouse/Partner’s Occupation

  • Ico textbox

    Person to contact in an emergency

  • Ico textbox

    Phone

  • Ico multiline

    Address

  • Ico textbox

    Relation to you

  • Ico integer

    No.

  • Ico textbox

    Insurance Co.

  • Ico textbox

    Ins.

  • Ico textbox

    Ages

  • Ico textbox

    Please list the major problems that you would like help with in therapy

  • Ico dropdown

    RATING

  • Ico multiline

    Briefly describe what motivated you to seek therapy at this time (rather than some time earlier o...

  • Ico checkbox

    Do you have any serious medical conditions?

  • Ico multiline

    (If yes, please describe)

  • Ico statictext

    Problems with:

  • Ico checkbox

    Headaches

  • ...and More!

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