Mental Health Intake Form

Form Template

The mental health patient intake form has several sections of client questions to ask before health care services are delivered, including family origin, medical history, criminal history and any problems that might be bothering the patient.

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This mental health patient intake form app also includes a disclosure form that can be signed prior to mental health treatment beginning.

This app makes it easy for a psychiatric nurse, mental health services counselor, or therapist to get a complete intake questionnaire for treatment of a patient experiencing symptoms of mental illness. The therapist can document current symptoms like anxiety, suicidal thoughts, trauma, and history of substance abuse. You can also add questions about previous care, history of prescription medications used and current primary care doctor. Improve overall psychiatric patient care by ensuring that you have all the details you need to deliver the highest standard of care.

  • 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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