Therapy Intake Form (Child)
Use this secure child therapy intake form to collect important background and behavioral information before a child’s first appointment. It’s a simple way to protect the sensitive information parents or guardians may share so you can build trust from the start. Send it by email or include it in a welcome packet on your website.
Form Template Preview
Submit this form to see what a completed submission looks like inside Hushmail:
Quick facts about this form
Who it's for:
- Therapists
- Counselors
- Psychologists
- Psychiatrists
- Behavioral health practices
Why use it:
- Learn what concerns or goals parents hope to address in therapy
- Show families you take privacy seriously with secure, HIPAA-compliant forms
- Start sessions with greater clarity and context
- Make a good impression with a seamless digital experience
Where to use it:
- In a welcome email after a child’s appointment is scheduled
- In a “New Clients” section on your website
- On your booking confirmation page
If your client skips a required field, the form will prompt them to fill it out. No more chasing after clients to fill out missing info.
Your client’s submission will live in Hushmail, where you can keep all submissions secure and organized in folders.
You can also download a PDF of the submission if you want to file a separate copy elsewhere, like your EHR.
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1.
You give us the form(s) you’re currently using in your practice.
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You get a dedicated Customer Care rep to oversee the service and answer questions.
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You end up with custom secure web forms that are easy for your clients to fill out.
