Practice operationsPractice templatePrint · PDF · Word
Solo practice intake questionnaire
Intake sections including culture, migration, and goals.
When to use: First session or async intake before session one — adapt to your jurisdiction.
Clinician tip: Leave clinical diagnosis to your assessment process; intake is breadth, not certainty.
Intake sections including culture, migration, and goals. Use the worksheet in session or as homework. Preview the layout on the right — tap it or choose View full preview below for the complete on-screen version.
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Create free accountRelated resources
- Practice operationsNew private practice — first 90 daysLaunch checklist: verification, listing, supervision, caseload.
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- Practice operationsBuilding affirming therapy spacesIntake language, office/telehealth cues, and repair when harm occurs — starting points.
- Practice operationsClinician burnout & sustainability checklistMonthly self-scan: load, boundaries, supervision, joy — not a diagnostic tool.
Disclaimer: For professional use in your practice only. Not emergency care. Not legal or medical advice. Customize templates for your jurisdiction and ethics code. You may use with clients; do not resell or republish as your own product without permission.