Intake Form Overview

  Permissions: Can invite clients to the client portal and manage intake forms must be selected in Default Permissions on a per staff basis to create and send Intake forms for staff with Default, Billing and Therapist permissions.
Administration and Organization Administration permissions include Intake forms.

Intake Forms are custom forms that are created to provide a client with information and/or to gather information from a client. There are forms included in the system by default and you can create any other form you use on a regular basis. They may include regular and dynamic elements and may be distributed in a number of ways. 

NOTE: You are not able to upload forms at this time. They must be recreated in the system.

Jump to  [Available Forms]  [Creating Intake Forms]  [Distributing Intake Forms]

Available Forms

General intake forms are include which can be edited to include specific information about your practice.

1. Notice of Privacy Practices - Describes how health information may be used and disclosed and how you can get access to this information.
2. Informed Consent for Psychotherapy - A generic consent to receive treatment based on the answers in the questionnaire.
3. Standard Intake Questionnaire - A basic questionnaire including sections on Complaint, Current Symptoms, Medical History, Family History, Present Situation and Additional information.
4. Credit / Debit Card Payment Consent - This form gives you permission to use the card on file for a Client. It does not collect all card information for a client because that would not be PCI compliant. Your Client needs to choose to save card on file while making their first payment in the Client Portal or add card to the Client Portal under Billing. It will not ask them for the CVV (again, due to PCI compliance) so you will need that information to process the card.
5. GAD-7 Scale - The GAD-7 is useful in primary care and mental health settings as a screening tool and symptom severity measure for the four most common anxiety disorders.
6. PHQ-2 Questionnaire - The PHQ-2 inquires about the frequency of depressed mood, with a score ranging from 0 to 6.
7. PHQ-9 Questionnaire - PHQ-9 total score for the nine items ranges from 0 to 27. In the above case, the PHQ- 9 depression severity score is 16 (3 items scored 1, 2 items scored 2, and 3 items scored 3).
8. Telehealth Treatment Consent - A voluntary consent form to conduct Telehealth sessions.

Creating Intake Forms

There are two ways to create Intake Forms:

1. Organization > Client Portal > Intake Forms tab
2. Creating a Dynamic form and copying the form to Intake Forms.

When creating intake forms you are provided a selection of both regular and dynamic form elements.

Regular Form Elements are used to both convey and collect information from the client:

• Section Header
• Short Answer
• Paragraph Answer
• Check Box
• Dropdown
• Text Box

Dynamic Form Elements pull information from client details:

• Client Full Name
• Client Email
• Client Mobile Number
• Client Id Number
• Client Date of Birth
• Client Address
• Client Diagnosis - can be included in the form but, as it is PHI, will not display on an intake form.

Distributing Intake Forms

Intake Forms can be sent to clients:

• automatically when they are invited to the Client Portal.
• sent, resent or revoked individually from General Documents when required.
• printed then, given to the client and scanned and uploaded to general documents after they are completed and returned.

Clients then login to the Client Portal and complete the intake forms. Once completed, the completed forms are stored in the General Documents tab of the Client profile.