Therapy Intake Form
What a therapy intake form asks, why each part matters, and how practices collect it.
A therapy intake form collects what a therapist needs before the first session: the reason for seeking help, mental health history, medications, and goals. It's also called a counseling intake form.
Therapy intake form, handled by an AI avatar
An AI healthcare assistant avatar asks the questions on a therapy intake form in the client's own language, strictly following the practice's instructions.
- Intake before the first session. Clients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the therapist. Therapists see what the client said before the session starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The therapist sees what matters up front and decides what needs attention first.
The form becomes a natural conversation: clients answer by talking, in their own words. The avatar is an information and client-assistance interface. It collects answers for the therapist to review. It doesn't diagnose, triage, or give treatment advice.
Sample therapy intake form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- What brings you to therapy now?Reason
- What would you like to be different?Reason
- Have you been in therapy or counseling before?History
- Have you had a mental health diagnosis?History
- How have you been sleeping lately?Symptoms
- How has your mood been in recent weeks?Symptoms
- Do you take any medicine for your mood?Medications
- Who prescribes your medicines?Medications
- What would you like to get out of therapy?Goals
- How will you know therapy is helping?Goals
- Who do you live with?Life
- Who do you turn to for support?Life
These are examples to read, not a form to fill in.
Therapy intake form: FAQ
What is a therapy intake form?
It's the form a therapist uses to learn about a new client before the first session: why they're seeking help, their history, medications, and goals.
What is an intake form for counseling?
The same form under another name. Counselors use it to understand a new client's situation and plan the first sessions.
Is there a therapy intake form template?
The sample questions on this page show a typical set. Every practice adapts them to its own approach and clients.
Who fills in the form?
The client, or a parent or guardian for a child. The therapist reviews it before or during the first session.
What questions are on a therapy intake form?
The sample questions on this page cover six areas: the reason for seeking help, mental health history, current symptoms, medications, goals for therapy, and life and relationships.
What happens after the client fills it in?
The therapist reads it before or during the first session and uses it to plan the first steps of care.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
