Biopsychosocial Intake Form Template for Australia

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Key Requirements PROMPT example:

Biopsychosocial Intake Form

"I need a Biopsychosocial Intake Form for my new psychology practice opening in March 2025, with a focus on trauma-informed care and incorporating Aboriginal and Torres Strait Islander cultural considerations."

Document background

The Biopsychosocial Intake Form is a fundamental document used in Australian healthcare settings to establish a comprehensive understanding of a client's health status and circumstances at the commencement of care. This document is typically used during initial consultations or patient onboarding processes, gathering essential information across biological, psychological, and social domains. It complies with Australian healthcare regulations, including the Privacy Act 1988, state-specific health records legislation, and mental health acts. The form includes sections for personal information, medical history, mental health assessment, social circumstances, and risk evaluation, while incorporating necessary consent and privacy acknowledgments. It serves as a foundation for treatment planning and ongoing care management, ensuring healthcare providers have access to relevant patient information while maintaining appropriate privacy and confidentiality standards.

Suggested Sections

1. Client Information: Basic demographic information including name, date of birth, contact details, and preferred contact method

2. Emergency Contact Information: Details of primary and secondary emergency contacts

3. Insurance and Billing Information: Healthcare insurance details, Medicare number, and preferred payment method

4. Current Health Concerns: Primary reason for visit and current symptoms or concerns

5. Medical History: Past medical conditions, surgeries, hospitalizations, and current medications

6. Mental Health History: Previous mental health treatments, diagnoses, and medications

7. Family Medical History: Relevant family medical and mental health history

8. Social History: Living situation, employment, education, and social support systems

9. Lifestyle Factors: Sleep patterns, exercise, diet, substance use, and daily activities

10. Risk Assessment: Current or historical risk factors for self-harm or harm to others

11. Consent and Privacy: Informed consent for treatment and privacy policy acknowledgment

Optional Sections

1. Cultural and Spiritual Assessment: Assessment of cultural background, beliefs, and spiritual practices that may impact treatment - used when cultural factors are particularly relevant to care

2. Trauma History: Detailed assessment of past trauma experiences - used when trauma-informed care is indicated

3. Pain Assessment: Detailed pain evaluation including location, intensity, and impact - used for clients presenting with chronic pain

4. Developmental History: Early childhood development and milestone assessment - used primarily for younger clients or when developmental factors are relevant

5. Educational/Occupational Assessment: Detailed assessment of educational and work history - used when vocational or educational factors are primary concerns

6. Legal History: Information about current or past legal issues - used when legal factors may impact treatment

7. Reproductive Health History: Assessment of reproductive health and related concerns - used when relevant to presenting problems

Suggested Schedules

1. Mental Health Screening Tools: Standardized assessment tools such as depression (PHQ-9) and anxiety (GAD-7) scales

2. Pain Diagram: Body diagram for marking areas of pain or physical symptoms

3. Activities of Daily Living Assessment: Detailed checklist of daily functioning capabilities

4. Privacy Policy: Detailed privacy policy and information handling procedures

5. Consent Forms: Specific consent forms for treatment, information sharing, and record keeping

6. Crisis Management Plan: Template for developing safety and crisis management strategies

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Mental Health Services

Allied Health

Social Services

Disability Services

Rehabilitation Services

Community Health

Private Practice

Public Health

Relevant Teams

Clinical Operations

Mental Health

Patient Services

Medical Records

Administration

Quality Assurance

Compliance

Healthcare Services

Front Desk

Patient Care

Relevant Roles

Psychologist

Psychiatrist

General Practitioner

Mental Health Nurse

Social Worker

Occupational Therapist

Clinical Director

Practice Manager

Intake Coordinator

Healthcare Administrator

Medical Records Officer

Clinical Psychologist

Counsellor

Case Manager

Allied Health Professional

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