Patient Intake Form: Professional, concerned
& compationate psychiatric care.


Intake Form

The form also includes questions about the patient’s social and family history, such as their living situation, relationships, and employment status. There are also questions about the patient’s substance use history and any history of trauma or abuse.

In addition to these questions, the form includes several rating scales to assess the severity of the patient’s symptoms and their overall level of functioning. The rating scales cover areas such as depression, anxiety, and sleep disturbances.

Overall, the patient intake form is a comprehensive tool designed to help mental health professionals gather important information about their patients before their first appointment. By collecting this information ahead of time, mental health professionals can better understand their patients’ needs and develop more effective treatment plans.

Download and complete our Patient Intake Forms.  You can bring them to your first appointment or email them to us.
Click HERE to email your forms.