A therapy intake form asks for contact details, the type of therapy, session format and availability, focus areas, and any practical or accessibility needs.
Reaching out for therapy & counselling can feel like a lot, and the first hurdle is often the admin: enough detail to book an intake, without turning the first contact into a full disclosure. The therapy intake form keeps that first step steady, asking only for contact details, the kind of support being asked for, and what needs to happen next, on an olive page with magenta button cues under Raleway headings and Roboto body text.
The opening note explains that the details go toward arranging a first session, and that questions about notes, session length, and what to expect can be answered before anything moves forward. The form then collects a name, email, and optional phone number, followed by the enquiry details: which service the person is looking for, whether the session needs to be in person, online, or phone only, and which days and times tend to work.
- Therapy Intake Form A short introduction that says the form is for arranging an intake, and that questions about notes, session length, and what to expect can be covered before the first session.
- Your details Required name and email fields, plus an optional phone number, so follow-up doesn’t depend on a single contact method.
- About your enquiry Questions covering the service being enquired about and the preferred session format, so the right kind of intake can be arranged.
- Preferred days and times A required scheduling notes field where the person can share availability in their own words.
- Focus and needs Optional prompts for what the person wants to focus on and any practical or accessibility needs, so the first session starts with context.
Once the form is in your workspace, Plutio collects responses in one place, so the intake requests don’t end up split across emails and messages. The same link can be shared whenever a new enquiry comes in, and each submission arrives with the choices and written answers attached.
We went from spending hours on every proposal to creating fully customized ones in under 5 minutes. That's not an exaggeration - we timed it.
What to include in a therapy intake form
| Part | What it covers |
|---|
Therapy Intake Form | An opening note that says the form is used to arrange an intake for therapy and counselling, with space to answer questions about notes, session length, and what to expect. |
Your name | A required full name field, so the intake can be booked under the right details. |
Email address | A required email field for confirmations and follow-up questions. |
Phone number | An optional phone field, in case a call works better than email. |
About your enquiry | A short prompt that asks which session the person wants and when tends to suit them. |
Which service are you enquiring about? | A required choice between options like individual psychotherapy, couples counselling, family therapy, trauma counselling, grief and loss, and stress and burnout counselling. |
Preferred session format | A required choice for in-person at the office, an online video call, or phone call only. |
Preferred days and times | A required text area for availability, written in the person’s own words. |
What would you like to focus on in sessions? | An optional text area for goals, concerns, or themes the person already knows they want to bring. |
Any practical or accessibility needs I should know? | An optional field for practical notes and accessibility needs that affect how sessions should run. |
Who it is for
Counsellors, psychotherapists, and therapy practices that need a consistent intake process for individual therapy and couples counselling enquiries.
The form in full
Therapy Intake Form
This form collects details to arrange an intake for therapy and counselling. I will contact you to arrange the first session and answer questions about notes, session length, and what to expect.
- Your name (required)
- Email address (required)
- Phone number
About your enquiry
Tell me which session you want and when suits you.
- Which service are you enquiring about? (required)
- Individual psychotherapy sessions
- Couples counselling sessions
- Family therapy sessions
- Trauma counselling sessions
- Grief and loss counselling sessions
- Stress and burnout counselling sessions
- Preferred session format (required)
- In-person at my office
- Online video call
- Phone call only
- Preferred days and times (required)
- What would you like to focus on in sessions?
- Any practical or accessibility needs I should know?
