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Therapy Intake Form
"I need a Therapy Intake Form for my private psychology practice in London that specializes in cognitive behavioral therapy, compliant with GDPR and including specific sections for trauma assessment and online therapy consent."
1. Personal Information: Basic client details including name, contact information, and emergency contacts
2. Medical History: Current and past medical conditions, medications, and treatments
3. Mental Health History: Previous mental health treatments and diagnoses
4. Consent for Treatment: Client's agreement to receive therapy services
5. Confidentiality Statement: Information about privacy policies and limits of confidentiality
6. Payment and Cancellation Policies: Financial arrangements and appointment policies
1. Risk Assessment: Additional assessment section for clients presenting with potential risk factors - used when working with high-risk clients or required by insurance
2. Parent/Guardian Consent: Additional authorization section for treating minors or those lacking capacity - used when client is under 18 or lacks mental capacity
3. Insurance Information: Section for health insurance coverage details - used when accepting insurance payments
1. Privacy Notice: Detailed GDPR-compliant privacy information
2. Client Rights and Responsibilities: Detailed explanation of therapy relationship expectations
3. Crisis Support Information: Emergency contact numbers and resources
Authors
Therapeutic Relationship
Confidentiality
Clinical Notes
Treatment Plan
Crisis Situation
Emergency Contact
Session
Informed Consent
Personal Data
Special Category Data
Data Processing
Client Records
Professional Standards
Safeguarding
Duty of Care
Privacy Notice
Disclosure
Risk Assessment
Mental Capacity
Clinical Assessment
Therapeutic Contract
Cancellation Policy
Payment Terms
Professional Boundaries
Consent for Treatment
Confidentiality
Emergency Procedures
Payment Terms
Cancellation Policy
Data Protection
Record Keeping
Information Sharing
Professional Boundaries
Crisis Management
Service Limitations
Communication Methods
Rights and Responsibilities
Complaints Procedure
Termination of Services
Safeguarding
Risk Management
Electronic Communications
Insurance and Liability
Medical History
Mental Health History
Therapeutic Approach
Session Duration
Referral Process
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