Client Intake Form Template for Australia

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Key Requirements PROMPT example:

Client Intake Form

"I need a Client Intake Form for my psychology practice in Melbourne that includes detailed mental health history sections and Medicare information collection, ensuring compliance with Australian healthcare privacy standards and mental health regulations."

Document background

The Client Intake Form serves as a crucial first step in establishing a professional relationship between service providers and clients in the Australian market. This document is designed to be used at the commencement of a new client relationship, collecting vital information necessary for service delivery while ensuring compliance with Australian privacy laws, consumer protection regulations, and industry-specific requirements. The form includes sections for personal information, service requirements, consent declarations, and other relevant details, structured to meet the needs of various service providers while maintaining consistency with Australian Privacy Principles and state/federal legislation. It is particularly important for businesses that need to maintain detailed client records and those subject to professional standards or regulatory oversight.

Suggested Sections

1. Client Personal Information: Basic contact details including full name, address, phone, email, and preferred contact method

2. Identity Verification: Details of identification documents provided to verify client identity

3. Emergency Contact Information: Secondary contact details in case of emergencies

4. Service Requirements: Primary reason for seeking services and immediate needs

5. Medical Information: Relevant health information that may impact service delivery

6. Privacy Statement: Explanation of how personal information will be collected, used, and protected

7. Consent Declaration: Client's acknowledgment and consent to information collection and use

Optional Sections

1. Insurance Details: Include when services may be claimed through insurance

2. Cultural Considerations: Include for services where cultural background may impact service delivery

3. Billing Information: Include when direct billing or recurring payments are required

4. Professional Referral Details: Include when client is referred by another professional

5. Accessibility Requirements: Include when services require physical attendance or specific accommodation needs

6. Guardian Information: Include when client is a minor or requires authorized representative

Suggested Schedules

1. Schedule A - Service Menu: Detailed list of available services and associated costs

2. Schedule B - Terms and Conditions: Detailed terms of service delivery and client agreements

3. Schedule C - Privacy Policy: Detailed privacy policy and data handling procedures

4. Appendix 1 - Consent Forms: Specific consent forms required for different types of services

5. Appendix 2 - Client Rights and Responsibilities: Detailed explanation of client rights and responsibilities

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

Professional Services

Legal Services

Financial Services

Education

Mental Health Services

Allied Health

Social Services

Consulting

Personal Services

Medical Practice

Therapy Services

Accounting Services

Relevant Teams

Client Services

Operations

Administration

Compliance

Front Desk

Customer Relations

Legal

Practice Management

Quality Assurance

Data Management

Relevant Roles

Practice Manager

Client Services Manager

Compliance Officer

Business Owner

Professional Practitioner

Office Administrator

Intake Coordinator

Client Relations Manager

Operations Manager

Healthcare Provider

Legal Professional

Financial Advisor

Education Provider

Therapist

Consultant

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Authors

Alex Denne

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