Intake Assessment

This is an extensive assessment for your intake session.

You can change the wording, add sections and delete the parts that do not apply to your practice.


Intake Assessment


This is a 13 page word document with space to collect demographic, family and clinical information during intake appointments of adult clients.

Headings include:

  • Demographic
  • History of Therapy
  • Goals
  • Health
  • Sleep
  • Feminine Health
  • Risk
  • Nutrition
  • Substance Use
  • Family
  • Relationships
  • Education & Career

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Intake Assessment
Intake Assessment


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