Adult Intake Form Template

## What's Included

This Adult Intake Form Template is designed to comprehensively capture essential client information during the initial clinical or mental health assessment. It includes sections for demographic data, presenting problems, mental health history, medical history, substance use, family and social history, and current functioning. The template also features standardized fields for documenting risk factors such as suicidality and self-harm, as well as screening questions for trauma and abuse. Additionally, there are components for recording the client’s goals for therapy and any prior treatment or medication history.

Structured to facilitate thorough clinical documentation, the form incorporates checkboxes, rating scales, and free-text areas to ensure both quantitative and qualitative data are collected efficiently. It also contains consent and confidentiality statements, emergency contact information, and space for clinician observations and initial impressions. This template supports a holistic understanding of the client’s mental health status, enabling clinicians to plan appropriate interventions from the outset.

## Who This Template Is For

This template is ideal for psychologists, licensed clinical social workers (LCSWs), marriage and family therapists (MFTs), counselors, psychiatrists, and other mental health professionals conducting adult client intakes in outpatient or community mental health settings.

## How to Use

Begin by reviewing the template with the client during the initial session, ensuring all demographic and contact information is accurately recorded. Use the structured fields to guide the clinical interview, systematically addressing mental health history, substance use, and risk factors. Encourage clients to elaborate on open-ended questions in the narrative sections to capture context and nuance. Document behavioral observations and clinical impressions in the designated areas to support diagnostic formulation.

After the intake is complete, review the form for any missing information and clarify as needed in follow-up sessions. Integrate this documentation into the client’s electronic health record (EHR) or paper chart, using the data gathered to inform treatment planning, goal setting, and subsequent progress notes. This intake form serves as a foundational document for ongoing clinical work and coordination of care.

## Customize with MentalNote

With MentalNote AI, you can automatically generate this Adult Intake Form tailored to your specific clinical practice and documentation style directly within Microsoft Word. By leveraging MentalNote’s intelligent prompts and customizable templates, clinicians save time creating comprehensive intake documents that comply with best practice standards. MentalNote also allows seamless integration of client-specific data and generates professional, editable forms that enhance clinical workflow and reduce administrative burden.