intake form examples

5 Intake Form Examples That Work in Real-Time

Garima Singh
By Garima Singh | January 24, 2024 9:55 am

A client questionnaire, particularly in the context of creating a website, is usually the initial point of contact between a customer and a service-oriented company, often comprising inquiries regarding the client's requirements and background for their website project. As an entrepreneur in the web development sector, this questionnaire can assist you in several key areas:

  • Evaluate the compatibility of a client with your business model and website creation services
  • Facilitate the development of a tailored website proposal for prospective clients
  • Equip you for initial consultations or ongoing client engagements related to website design and development
  • Streamline client management processes through automation, particularly in the web creation workflow

Optimizing the structure of your client questionnaires for website projects may require some experimentation. Below, you'll find several tips and examples to expedite this process.

Tips for Setting Up Intake Forms

Setting up effective intake forms is a crucial step in streamlining your client management process, especially in fields like counseling, massage therapy, and healthcare. These forms not only gather essential information but also shape the initial impression of your services. Here are some strategies to enhance your intake forms:

  • Ask Questions That Set You Up for Success: Tailor your questions to gather the most relevant information, be it for massage intake forms or counseling sessions. This ensures you are well-prepared to meet your client's needs.
  • Customize Your Forms by Appointment or Client Type: Different services, such as counseling or massage therapy, require different types of information. Customize your forms accordingly to collect the most pertinent data.
  • Keep Forms Organized: Well-structured forms, whether they are patient intake forms for healthcare or client intake forms for a business website, should be easy to navigate and fill out.
  • Take the Opportunity to Get to Know Your Clients: Use the intake process as a chance to understand your client’s expectations and preferences, especially in personal services like counseling or massage therapy.
  • Think About When to Deliver Your Form: Timing is key. Decide whether the intake form should be sent before booking, before a first appointment, or for recurring visits.

Intake Form Examples

Creating an effective intake form using form builders is essential for gathering the right information from your clients. Below are five diverse intake form templates, each tailored to specific service needs. These examples cover a range of fields, from counseling and massage therapy to general patient and client services.client intake forms

Massage Intake Form

Date: __________ Personal Information: - Name: ___________________________ - Date of Birth: ___________________ - Address: ________________________ - Phone: __________________________ - Email: __________________________ Health Information: - Do you have any allergies? _________________________ - Are you currently receiving medical treatment? _______ - List any medications: _____________________________ - Please describe any physical discomfort or areas of concern: _______________ Massage Preferences: - Preferred pressure (light, medium, firm): ___________ - Specific areas to focus on: ________________________ - Areas to avoid: __________________________________ - Goals for your massage therapy sessions: ___________ Signature: _________________________

This template focuses on collecting health-related information, specific physical concerns, and personal preferences regarding massage therapy. It includes sections on medical history, areas of discomfort, and massage therapy goals.

Intake Forms for Counseling

Date: __________ Personal Information: - Name: ___________________________ - Date of Birth: ___________________ - Address: ________________________ - Phone: __________________________ - Email: __________________________ Background Information: - Current employment/schooling status: ________________ - Relationship status: ______________________________ - Brief family background: ___________________________ Health and Wellness: - Current physical health (e.g., sleep, appetite): _______ - History of mental health concerns: __________________ - Current stressors or life challenges: _________________ Counseling Goals: - What brings you to counseling? ______________________ - What are your goals for therapy? ____________________ Signature: _________________________

Designed for mental health professionals, this form collects client information pertinent to counseling sessions. It includes personal background, mental health history, reasons for seeking counseling, and therapeutic goals.

Patient Intake Forms for Healthcare Providers

Date: __________ Personal Information: - Name: ___________________________ - Date of Birth: ___________________ - Address: ________________________ - Phone: __________________________ - Email: __________________________ Medical History: - Major illnesses/surgeries/hospital stays: ____________ - Family health history: ____________________________ - Current medications and dosages: ___________________ - Allergies (medication, food, others): _______________ Current Symptoms: - Description of current symptoms: ___________________ - Duration of symptoms: ____________________________ - Previous treatments and their effectiveness: _________ Lifestyle Information: - Diet and exercise routine: __________________________ - Smoking/alcohol consumption: ______________________ Signature: _________________________

Essential for healthcare settings, this template gathers comprehensive medical history, current symptoms, medications, and family health history. It's designed to provide healthcare providers with a complete view of the patient's health status.

Client Intake Forms for Business Services

Date: __________ Client Information: - Name/Company: ___________________ - Contact Person: __________________ - Address: ________________________ - Phone: __________________________ - Email: __________________________ Project Details: - Description of the service required: ________________ - Desired outcomes and objectives: __________________ - Project timeline: _________________________________ - Budget: ________________________________________ Preferences and Specifications: - Specific requirements or preferences: _______________ - Any previous experience with similar services: ________ - Key points of contact and communication preferences: _ Signature: _________________________

Ideal for service-based businesses, this form focuses on client needs, project scope, and specific service preferences. It's designed to help service providers understand client expectations and tailor their approach accordingly.

Online Intake Forms for Virtual Services

Date: __________ Client Information: - Name: ___________________________ - Date of Birth: ___________________ - Address: ________________________ - Phone: __________________________ - Email: __________________________ Service Preferences: - Specific services you are interested in: _____________ - Preferred days and times for appointments: _________ - Technology access and proficiency: _________________ Goals and Expectations: - What do you hope to achieve with our services? _______ - Any previous experience with virtual services? ________ Additional Comments: - Please share any other relevant information or questions you might have: ____ Signature: _________________________

This template is geared towards services offered remotely. It includes contact information, service preferences, and specific questions relevant to the virtual nature of the service, such as technology comfort level and availability.

How to Incorporate Intake Forms into Your Business

Integrating intake forms effectively into your business operations can significantly enhance efficiency and client satisfaction. Here’s how:
  • Before Booking: Online intake forms can be used as a preliminary step before a client books an appointment, helping you gauge their needs and expectations.
  • Before a First Appointment: This is a crucial time to gather detailed information, whether it's patient intake forms in a healthcare setting or client intake forms for a consultation.
  • For Recurring Appointments: Update forms for regular clients to keep track of any changes or developments since their last visit. This is particularly relevant in ongoing services like counseling or healthcare.


Intake forms, whether they are for counseling, massage therapy, or any client-based service, are more than just paperwork. They are a vital tool in understanding and meeting the needs of your clients, ensuring a smooth and efficient service delivery. By following these tips and utilizing the provided examples and templates, you can create intake forms that not only gather essential information but also enhance the overall client experience.

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