Intake Forms
Good Faith Estimate for Mental Health Services (Forms Template)

This form can be used by mental health providers to full the required good faith estimates of expected charges. This requirement goes into effect in January 2022.  A Good Faith Estimate must be provided within 3 business days. Information regarding services must be furnished within 1 business day of scheduling a service to be provided in 3 business days and within 3 business days of scheduling a service to be provided in at least 10 business days.  We recommend using the Psychology Forms Filler to individualize this form for your practice.   (2021, practice management, financial, forms)

Treatment by Intern – Informed Consent

This form can be used to give clients informed consent when treatment is being provided by an intern. (0421)

Couples Therapy Intake Form

This form can be used as a model for obtaining intake information when treating couples. (0720)

Coaching Intake Checklist

This form helps coaches set the stage for a productive relationship with clients.