Ten questions do almost all of the work. Everything else is either a follow-up or a field you are collecting out of habit.

• What brings you now — and why now rather than six months ago?

• What would be different if this worked?

• Have you been in therapy before? What helped, what didn't?

• Who else is involved in your care right now — family doctor, psychiatrist, anyone else?

• Any medication, and any changes to it recently?

• What does a hard week look like? What does a good one look like?

• Who is around you — who would notice if things got worse?

• Are you having thoughts of suicide or of hurting yourself? Have you before?

• Where will you be sitting when we meet — which province?

• How do you want me to contact you, and can I leave a message?

The last two are the ones a borrowed American template will not have, and they are both administrative questions with clinical consequences.

Which of these does anyone require?

None of them, as questions. What is published is what the record has to hold. Ontario's psychology College asks for "A description of any presenting problem and of any history relevant to the problem" (CPBAO Standard 9.2), and Alberta's psychology standards ask for the "date and substance of each professional service, including relevant information on issues discussed" (CAP Standard 7.1.4).

So the wording is yours. What is not optional is that the answers end up written down.

What should I ask about risk?

Ask directly, at the first contact, and ask again later. The published guidance is not about the wording of the question — it is about what you have arranged in advance for the answer.

Ontario social work sets out three things to do when working at a distance, including "developing a safety plan with the client, which includes asking them for the contact information for, and permission to contact, another person in the event of an emergency or service interruption" (OCSWSSW 5.3.2). Note both halves: the contact information and the permission. An emergency contact you are not permitted to call is a phone number, not a plan.

Ontario's psychotherapy College lists, among what an electronic-practice agreement should address, "Steps to be taken in the event of a technology disruption or when a client is in crisis" (CRPO Electronic Practice Guideline). In Canada that generally means 9-1-1 for immediate danger and 9-8-8, the Suicide Crisis Helpline, which takes both calls and texts and describes itself as "24/7/365 Crisis Support" (9-8-8). Check anything you name still runs the hours you think it does before you print it.

Why ask which province they will be in?

Because it decides whether you can see them at all. Ontario's psychotherapy standard is a numbered clause: "Registrants comply with relevant professional licensing requirements in the jurisdictions where clients are located" (CRPO 3.4.5). Ontario social work says the same thing from the client's side — "The key factor is the client's location during the service, not the registrant's location" (OCSWSSW).

Ask it as a live question, not a mailing address. People move, study away, and work from a cottage in another province for two months a year.

Why ask how they want to be contacted?

Because the answer is a consent, and it has to exist before you use the channel. The counselling therapy standards adopted in Nova Scotia require the practitioner to "clarify under which circumstances and for which purposes technology-based-communication will be used (e.g., setting up appointments, counselling sessions, record-keeping, billing, assessment, third-party reporting)" (CCPA Code of Ethics, H3), and they add a line most forms leave out: if a client declines a channel, offer another — "if a client were to decline using email for correspondence, then telephone should be offered as an alternative."

Two sub-questions do the whole job. May I text you about scheduling? May I leave a voicemail, and how much may it say?

Which questions belong on the form, and which in the room?

Put the answerable ones on the form — names, dates, contact, medication, who else is involved. Those are tedious to say out loud and easy to write.

Keep the ones with a hinge in them for the conversation. "What brings you now" gets a paragraph on paper and twenty minutes in a room, and the twenty minutes is the point. A long trauma inventory filled in alone by someone who has not yet met you is the clearest example of a question in the wrong place.

How many is too many?

The federal privacy commissioner gives a usable test: "Individuals cannot be required to consent to the collection, use or disclosure of personal information beyond what is necessary to provide the product or service" (OPC).

Applied to an intake pack, that reads: if you cannot say what you would do differently based on the answer, do not ask it yet.

A script for the first call

Worth having written down, because the first call usually arrives while you are between sessions.

Thanks for calling, {{name}}. Before we book, three quick things — what's bringing you in, which province you'll be in when we meet, and whether it's all right to text you about scheduling. I'll send the rest as a form.

Three questions, under a minute, and they cover the two that a form borrowed from somewhere else will not have asked.

About Rivet

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