All Countries
Employment
Simple Intake Form

Simple Intake Form Template for New Zealand

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Simple Intake Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Simple Intake Form

"I need a Simple Intake Form for my physiotherapy practice that includes sections for medical history and ACC claims, compliant with NZ healthcare regulations and ready to implement by March 2025."

Celebrated by
Collaborations with
Investors
Document background
The Simple Intake Form is a foundational document used by service providers in New Zealand to gather essential information from new clients or customers. This document is designed to comply with New Zealand's Privacy Act 2020 and other relevant legislation, ensuring proper collection and handling of personal information. The form serves as the first formal point of contact between the service provider and client, capturing necessary details such as personal information, contact details, and service-specific requirements. It includes mandatory privacy notices and can be customized with optional sections depending on the nature of services being provided. The Simple Intake Form is particularly valuable for businesses and organizations that need to maintain detailed client records while ensuring compliance with New Zealand's privacy and data protection requirements.
Suggested Sections

1. Personal Information: Basic identification details including full name, date of birth, and preferred name

2. Contact Details: Primary contact information including address, phone, email, and preferred contact method

3. Emergency Contact: Details of emergency contact person including relationship and contact information

4. Privacy Notice: Statement explaining how personal information will be collected, used, stored and shared, in compliance with Privacy Act 2020

5. Declaration: Client confirmation that information provided is accurate and acknowledgment of privacy notice

6. Signature Block: Space for client signature (physical or electronic) and date

Optional Sections

1. Medical Information: Include when service involves health-related aspects - captures relevant medical history, conditions, and medications

2. Cultural Information: Include when service requires cultural sensitivity - captures ethnicity, iwi affiliations, language preferences

3. Payment Information: Include when service requires payment - captures billing details and preferred payment method

4. Service Preferences: Include when multiple service options are available - allows client to indicate preferred service types or timing

5. Disability Support Needs: Include when accessibility accommodations might be needed - captures specific support requirements

Suggested Schedules

1. Privacy Policy: Detailed privacy policy explaining how personal information is handled

2. Service Description: Detailed description of services offered, if relevant to intake process

3. Fee Schedule: List of applicable fees and charges, if relevant to service

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

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Relevant Industries

Healthcare

Professional Services

Education

Social Services

Financial Services

Legal Services

Consulting

Mental Health Services

Community Services

Fitness and Wellness

Relevant Teams

Reception

Administration

Client Services

Operations

Customer Support

Compliance

Front Office

Client Relations

Service Delivery

Quality Assurance

Relevant Roles

Office Manager

Client Services Coordinator

Administrative Assistant

Practice Manager

Intake Coordinator

Customer Service Representative

Operations Manager

Business Administrator

Front Desk Coordinator

Client Relations Manager

Compliance Officer

Service Coordinator

Industries
Privacy Act 2020: Governs how personal information must be collected, used, stored, and disclosed. Ensures compliance with privacy principles and data protection requirements.
Contract and Commercial Law Act 2017: Provides the legal framework for formation and enforcement of contracts, including requirements for valid agreements and documentation.
Fair Trading Act 1986: Ensures fair business practices and prohibits misleading or deceptive conduct in trade, including in the collection of customer information.
Electronic Transactions Act 2002: Regulates electronic transactions and ensures electronic forms have the same validity as paper documents, if the form is to be completed electronically.
Human Rights Act 1993: Prohibits discrimination in various contexts and ensures that intake forms do not unfairly discriminate based on protected characteristics.
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

Find the exact document you need

Simple Intake Form

A New Zealand-compliant intake form for collecting and managing client information, structured according to NZ privacy laws and business requirements.

find out more

New Patient Intake Form

A New Zealand-compliant form for collecting essential medical and personal information from new patients, meeting all local healthcare regulatory requirements.

find out more

Intake Form For Massage Therapy

A New Zealand-compliant intake form for massage therapy services that captures client health information, consent, and treatment preferences.

find out more

Basic Intake Form

A New Zealand-compliant intake form for collecting and managing client information, designed for use across various service sectors.

find out more

Business Intake Form

A New Zealand-compliant Business Intake Form for collecting and verifying essential business client information and establishing formal business relationships.

find out more

Virtual Assistant Client Intake Form

A New Zealand-compliant intake form for establishing virtual assistant services, collecting client information and service requirements while ensuring legal compliance.

find out more

Health Intake Form

A New Zealand-compliant health intake form for collecting essential patient information and medical history in healthcare settings.

find out more

Nutrition Intake Form

A New Zealand-compliant health information collection form for gathering client dietary, health, and medical history data for nutritional assessment and planning.

find out more

Project Intake Form

A standardized New Zealand-compliant form for capturing and assessing new project proposals, including key project parameters and requirements.

find out more

Real Estate Client Intake Form

A New Zealand-compliant real estate client intake form for collecting essential client information and meeting regulatory requirements.

find out more

Intake Referral Form

A New Zealand-compliant intake referral form for coordinating client transfers between healthcare and social service providers.

find out more

Client Intake Assessment Form

A New Zealand-compliant form for gathering and assessing new client information, establishing service requirements and obtaining necessary consents.

find out more

Massage Consent Form

A New Zealand-compliant massage therapy consent form capturing client health information and treatment authorization while ensuring privacy protection and professional standards.

find out more

Referral Intake Form

A New Zealand-compliant healthcare referral intake form for documenting patient referrals and managing information transfer between healthcare providers.

find out more

Case Management Intake Form

A New Zealand-compliant intake assessment form for case management services, collecting essential client information and care requirements.

find out more

Bookkeeping Client Intake Form

A New Zealand-compliant intake form for establishing bookkeeping services, capturing essential business and financial information while meeting local regulatory requirements.

find out more

Salon Client Intake Form

A New Zealand-compliant salon client intake form for collecting essential client information and consent for beauty and wellness services.

find out more

Client Intake Form

A New Zealand-compliant Client Intake Form for collecting essential client information and consents, aligned with Privacy Act 2020 requirements.

find out more

Procurement Intake Form

A New Zealand-compliant internal form for initiating and documenting procurement requests, ensuring alignment with local procurement rules and regulations.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: https://www.genieai.co/our-research
Oops! Something went wrong while submitting the form.

Genie’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; Genie’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our Trust Centre for more details and real-time security updates.

Read our Privacy Policy.