Client intake form for a therapy practice in Ireland: what to include
A good intake form does two jobs at once: it gets a new patient booked with the least possible friction, and it starts their clinical record off correctly. Get the balance wrong and you either ask for too much before you've even met someone, or too little, and spend the first ten minutes of session one filling in gaps that should already have been on file.
What belongs on a pre-booking intake form
Keep this short — every extra field is a chance for someone to abandon the form before they book:
- Full name and contact details — email and phone, with a clear note on how you'll use each.
- Date of birth — relevant to session type, and to child/young-person safeguarding considerations if you see under-18s.
- What brings them to therapy, in their own words, briefly. One or two sentences, not a full history — that belongs in the room, not a public form.
- Whether this is their first time in therapy — shapes how you open the first session.
- Any current risk indicators you need to know before a first session — handled carefully, and always backed by a clear process for what happens if something concerning comes through a form outside session time.
- GP or referring practitioner, if relevant.
- Health insurer, as an optional field — useful later if they want to claim reimbursement; see our guide to health insurance reimbursement for therapy in Ireland for what a claim actually needs.
- How they found you — genuinely useful for your own practice, not the patient's clinical record.
What to leave for the first session, not the form
- Full clinical or psychiatric history. A form is a less controlled environment than a session — save the depth for when you're actually together.
- Diagnosis, medication details, or anything that reads as pre-judging the work before you've met.
- Anything you wouldn't be comfortable a third party seeing if the form were ever compromised — the golden rule for anything collected before a secure system and relationship are in place.
GDPR note: whatever your intake form collects becomes part of a patient's personal data the moment they submit it — encrypted storage, a clear lawful basis, and a stated retention period all apply from that point, not from the first session. See our full GDPR checklist for psychologists in Ireland for the detail.
Consent: two separate things, not one
GDPR consent (how you collect, store and use personal data) and consent to treatment (the therapeutic work itself) are related but distinct, and worth labelling separately rather than blending into one paragraph a patient skims past. Many practices handle GDPR consent briefly at intake and go through fuller informed consent to treatment properly at the first session, in person, where questions can actually be asked.
See how Nerela structures a patient record
Intake fields, session notes and reminders that fit together, not bolted on separately.
A simple structure to adapt
| Section | What goes in it |
|---|---|
| Contact & logistics | Name, date of birth, email, phone, preferred contact method, how they found you |
| Brief context | One or two sentences on what brings them to therapy; first time in therapy, yes/no |
| Practical | GP/referring practitioner (optional), health insurer (optional) |
| Consent | GDPR data-processing consent, clearly separated from consent to treatment (handled fully at session one) |
This structure fits comfortably on Nerela's patient intake fields, which stay with the record from booking through every session note that follows — no separate spreadsheet or paper form to reconcile afterward.
Frequently asked questions
Should my intake form ask for a diagnosis or clinical history up front?+
Keep the pre-booking form light and save clinical detail for the first session itself. A public-facing form is a less controlled environment than a session, and asking for sensitive clinical history before you've even met someone can also feel presumptive or off-putting. Contact details, basic context and practical logistics are enough to get someone booked.
Do I need separate consent for GDPR and for treatment?+
They're related but distinct. GDPR consent covers how you collect, store and use someone's personal data, and should be clear about what you collect, why, for how long, and what rights they have. Consent to treatment is a separate clinical and ethical matter about the therapeutic work itself. Many practices cover both at the first session with separate, clearly labelled sections rather than a single blended paragraph.
Should I ask for insurer details on intake?+
It's worth including as an optional field. If a patient may want to claim reimbursement from a private health insurer, having their insurer's name on file from the start means you don't have to chase it down later when they need a receipt formatted a particular way.
Intake, notes and reminders in one record
Nothing to reconcile between a form, a spreadsheet and your diary.
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