Initial Health Intake Form

Lesson 1, Topic 1
In Progress

Initial Health Intake Form February 4, 2020

On the following pages, we have included a sample of a health intake form that you may choose to adopt for your initial health intake. This is a more complete intake that is useful for your first contact with a guardian. You may find as a practitioner that you prefer a condensed version and can create a form similar based on your specific clientele. 

Your Initial Health Intake is where you are gathering all the health history on the client. You may not need to gather this information at each session, but you will want to refresh the Health Intake Form either annually, or whenever new circumstances demand it.

You may also use this form but only collect the pertinent information.  Just be sure that areas that are not needed have a Not Applicable or Unavailable or something similar to denote that you are not collecting that information. Forms must always be complete with no blanks for both insurance purposes where applicable and for your own documentation.

The other piece of documentation that you WILL need to create at each and every session is the SOAP Chart. We will cover the SOAP Chart later in this lesson, and provide both blank and completed forms.

For your information we have also included a health intake that has been completed. 

Initial Health Intake Form

Completed Health Intake Form