Therapy first session intake - Clean page

A gentle intake for a first counselling session: what brings you, goals, support, safety check and practical preferences. A quiet light page: underlined fields, plain choices and a comfort panel for text size and contrast.

About 6 min to complete. mental health, therapy, counselling, intake, minimal.

Questions in this template

1. Name you would like us to use
2. Email
3. Phone
4. What is bringing you to therapy?
5. In your own words, what would you like help with?
6. How have you been feeling this past week?
7. Have you seen a therapist before?
8. What helped, and what did not?
9. In the past two weeks, have you had thoughts of harming yourself?
10. If you are in danger right now, call your local emergency number. In the United States you can call or text 988 at any time.
11. How would you prefer to meet?

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