This free child therapy intake form sample gives clinicians a practical starting point for gathering child and family information before or during early sessions. The purpose is not to turn intake into a long questionnaire. It is to organize essential context, identify what still needs clarification, and create a clearer path from referral concerns to a working formulation and initial plan.
Professional-use sample. Use within your role, training, service procedures and local requirements.
What is the family hoping will be different?
What is already working or helping?
Which information needs to come from the child, school, records or another professional?
No. It is an organizational template. Diagnosis and assessment require appropriate professional training, methods and context.
That depends on your service. It can be completed in advance or used as a structured guide during intake, provided your privacy and consent procedures support that use.
No single intake form fits every jurisdiction or service. Review it against your organization, payer, legal and professional requirements before use.
Session PlanningFree Child Therapy Session PlannerA reusable quick session plan with goals, activities, observations and follow-up.
DocumentationFree Child Therapy Progress Note TemplateA general progress note template designed for flexible professional documentation.
Parent CollaborationFree Parent & Caregiver Therapy HandoutA shareable validation phrase guide for parent collaboration and between-session support.
Child Therapy Practice Essentials combines eight professional tools for intake, planning, session work, documentation, progress review and caregiver collaboration.