Client Intake Assessment Form Template for England and Wales

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Key Requirements PROMPT example:

Client Intake Assessment Form

"I need a Client Intake Assessment Form for my private therapy practice in London, focusing on mental health assessments and payment plans, with specific sections for trauma history and emergency protocols."

Document background
The Client Intake Assessment Form is a crucial document used across various professional services in England and Wales. It serves as the primary tool for gathering client information at the commencement of services, ensuring compliance with UK data protection laws and professional standards. This document is essential for establishing client needs, assessing risks, and creating appropriate service delivery plans. It helps organizations maintain consistent client onboarding processes while meeting their legal and regulatory obligations under UK law.
Suggested Sections

1. Client Personal Information: Basic contact details, identification, and demographic information including name, address, contact numbers, email, date of birth, and preferred contact method

2. Service Requirements: Primary reason for seeking services, immediate needs, and specific service requirements or preferences

3. Risk Assessment: Initial evaluation of potential risks and vulnerabilities, including safeguarding concerns and immediate risk factors

4. Consent and Privacy Notice: Data protection acknowledgments, processing consent, and confirmation of understanding regarding how information will be used

Optional Sections

1. Medical History: Details of relevant medical conditions, medications, and healthcare providers (used in healthcare settings or vulnerable client services)

2. Financial Assessment: Assessment of client's financial situation, income, expenditure, and ability to pay for services (used for fee-based services)

3. Cultural/Religious Considerations: Documentation of specific cultural or religious needs that may affect service delivery or require special accommodation

4. Emergency Contact Information: Details of next of kin or emergency contacts (used when ongoing service relationship is established)

Suggested Schedules

1. Privacy Policy: Detailed information about data protection practices, information sharing, and client rights under GDPR

2. Service Terms and Conditions: Complete terms of service provision, including rights, responsibilities, and limitations

3. Risk Assessment Matrix: Standardized framework for evaluating and scoring various risk factors and determining appropriate responses

4. Consent Forms: Collection of specific consent forms for various aspects of service provision and data sharing

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

Industries

UK GDPR and Data Protection Act 2018: Core data protection legislation governing how personal information must be collected, processed, and stored in the intake form. Requires clear privacy notices, lawful basis for processing, and data minimization principles.

Privacy and Electronic Communications Regulations (PECR): Regulations covering electronic communications, relevant if the intake form includes marketing consent or electronic communications preferences.

Equality Act 2010: Ensures the intake form doesn't discriminate against protected characteristics and requires reasonable adjustments for accessibility. Critical for fair treatment of all clients.

Mental Capacity Act 2005: Relevant when assessing client capacity to enter into agreements and making decisions. Important for vulnerable clients or those who may lack capacity.

Consumer Rights Act 2015: Protects consumer rights and ensures transparency in consumer contracts. Relevant if the intake form is used for consumer clients.

Consumer Contracts Regulations 2013: Governs contracts between traders and consumers, including information requirements and cancellation rights.

Professional Body Requirements: Specific regulations from relevant professional bodies (e.g., SRA for legal services, FCA for financial services) that may impact intake assessment requirements.

Health and Social Care Legislation: Including Health and Social Care Act 2012, Care Act 2014, and NHS Act 2006. Relevant if the intake form is used in healthcare or social care contexts.

Common Law Contract Principles: Fundamental principles of contract formation under English common law, including the Misrepresentation Act 1967.

Industry-Specific Regulations: Additional sector-specific regulations that may apply depending on the industry context of the client intake assessment.

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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