By
Adam Simmons
· Last checked
August 2026
A therapy intake form is shorter than the templates suggest. Most of the length in what you will find online is fields a Canadian solo practice never uses.
What earns its place, roughly in this order:
Identification — legal name, the name they want used, date of birth, address, phone, email.
How to reach them — which channels are all right, which are not, and whether you may leave a message.
Where they will be — the province they will be sitting in during sessions.
Emergency contact — a name, a number, and whether you have permission to use it.
What brings them — the presenting problem, in their own words.
Relevant history — previous therapy, current care, medication, anything a colleague picking this up would need.
Risk — current thoughts of suicide or self-harm, and what has happened before.
Money — the fee, the cancellation policy, how they pay, and the name the receipt goes in.
Everything else is either a different document or a question better asked out loud.
A therapy intake form is shorter than the templates suggest. Most of the length in what you will find online is fields a Canadian solo practice never uses.
What earns its place, roughly in this order:
Identification — legal name, the name they want used, date of birth, address, phone, email.
How to reach them — which channels are all right, which are not, and whether you may leave a message.
Where they will be — the province they will be sitting in during sessions.
Emergency contact — a name, a number, and whether you have permission to use it.
What brings them — the presenting problem, in their own words.
Relevant history — previous therapy, current care, medication, anything a colleague picking this up would need.
Risk — current thoughts of suicide or self-harm, and what has happened before.
Money — the fee, the cancellation policy, how they pay, and the name the receipt goes in.
Everything else is either a different document or a question better asked out loud.
Which of these are actually required?
No College publishes an intake form. What several publish is what the record has to contain, which is not the same thing — a form is one convenient way to collect it, and a first session is another.
Ontario's psychology and behaviour analysis College is the most specific. Its standard says each record must contain, verbatim:
"a. Identifying information about the client, including name, date of birth, address and (if available) telephone number and email address of each service recipient; b. Dates and details of every relevant or material service contact or consultation; c. A description of any presenting problem and of any history relevant to the problem"
That is one profession in one province. Read it as a floor for what the file needs to end up holding, not as a form specification.
What does a Canadian form need that an American one doesn't?
Four things, and the first is the one people miss.
The province, not the state — and it is not cosmetic. Where the client is sitting decides whose rules apply. Ontario's psychotherapy standard puts it in a numbered clause: "Registrants comply with relevant professional licensing requirements in the jurisdictions where clients are located" (CRPO 3.4.5). The social work College frames the same fact from the other side: "College registrants are permitted to practise with clients who are physically located in Ontario at the time of service provision. The key factor is the client's location during the service, not the registrant's location" (OCSWSSW). A single line on the form saves a hard conversation in month four when someone moves.
Consent to contact, named channel by channel. The counselling therapy standards adopted in Nova Scotia require a written policy on electronic communication and set out what it must convey: "in what instances these communications will be used (e.g., scheduling versus therapy)"; "what technologies will be used (text, email, other online messages apps)"; "any risks to privacy/confidentially associated with the particular technology being used"; and "anticipated response times" (CCPA Standards of Practice). Ontario social work asks that the consent simply be captured — "Clients may sign consent forms or provide verbal consent; College registrants shall document that consent was obtained" (OCSWSSW 5.2.1).
No insurance-verification block. There is no plan number to pre-authorise against. What replaces it is a receipt, and Ontario's psychotherapy College is the one place that publishes what a receipt must carry: "name of client; name of the registrant and their title; the registrant's registration number; name, date, and duration of the service provided; cost of service and method of payment" (CRPO Standard 6.1). So the form needs the legal name that will appear on that receipt, which is not always the name they introduce themselves by.
No authorisation page borrowed from US privacy law. Which privacy statute applies here depends on the province and sometimes on the profession, and a form that names the wrong one is worse than a form that names none.
What to leave off
Social insurance numbers. Health card numbers, unless you can say what you would do with one. Long trauma inventories filled in alone by someone who has not met you yet. Anything you have no plan to read.
The federal privacy commissioner's consent guidance is the cleanest 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). If you cannot finish the sentence "I collect this because…", the field goes.
Where does the form end and the consent begin?
Three documents get merged into one and then nobody can find anything. Keep them apart: the intake form collects facts, the informed consent covers the service itself, and the communications consent covers phone, text and email. The last one has its own list, and it is the one most often folded into the intake form and then lost.
Does it have to be on paper?
No. Ontario psychology's standard prefers writing and expressly allows secure technology: "Consent obtained in writing, physical or via secure technology, is preferred. However, oral consent is acceptable and must be documented in the client's file" (CPBAO Standard 7.1(c)).
Two things follow from collecting it electronically. Ontario social work asks registrants to "ensure that client information is stored in a jurisdiction where the privacy laws are consistent with Ontario laws or, where applicable, Canadian federal laws" (OCSWSSW 5.3.1) — so where the form software keeps its submissions is a question worth asking before you pick one. And whatever the client writes, they can later ask to see and to correct it: Ontario's health privacy statute gives "a right of access to a record of personal health information about the individual" and a right to "request in writing that the custodian correct the record" (PHIPA ss. 52, 55).
The short version
Eight blocks, one page, every field defensible. Collect the province, the channels and the legal name, because those three are the ones a borrowed template will quietly get wrong.
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