History Of Intake Forms

Intake forms, which are forms that generally ask detailed questions about the subject and subject’s history, are essential when a subject is being evaluated. For example, intake forms are required when becoming a new patient at a doctor’s office, when enrolling in a new school, or when applying for services. The information on the completed intake forms provide a starting point for the evaluator; it informs the evaluator of the subject’s history and present day status. Intake forms are pertinent to mental health facilities as it will inform the therapist or psychologist of the new client’s history, including but not limited to information about their medical history, educational background, family life, and overall development. This information

I did reach out to the facility telephonically to ask about multi-language intake forms and was informed that I could be emailed or postal mailed a Spanish intake form upon request.

Is there enough space to write what is needed in each answer space? Why or why not? Nearly every subsection of the form contains an other option for the client to write in additional answers. Most of the blank options are for the client to fill in dates, years, or ages to the reported answers. I feel like the area designated to write in the years, dates, and ages is sufficient, however, may be too condensed for the medical history portion where it requests that the client write down current medication and dosage. I believe this area is insufficient as there are only two three-inch lines for the client to list possible medications. Through experience, I have observed that clients coming into new services or treatment options are already on several medications, most of which contain long

Because there is not really any spacing between the categories, there is not a smooth transition from one topic of interest to the next. A client may have a difficult time making the transition to the next category on their own, thus resulting in confusion and frustration.

What would you include? What would you remove? Why? In addition to spacing the categories, I would also attempt to improve the form by consolidating subcategories so they only reflect pertinent and appropriate questions. For example, there is a subcategory labeled “Delayed Developmental Milestones” containing nearly twenty options of possible delayed milestones. I believe it would be most efficient to have three boxes under this sub category labeled “yes,” “no” and “unsure.”

I don’t think it’s efficient to list all twenty options because for the clients that are not familiar with their baby/childhood development, they will most likely leave the boxes blank. Does this mean they hit every milestone as expected?—not necessarily. This is why it would be more efficient to have an “unsure” option. I believe that the clients who do know/remember if they were delayed with their milestones, they would know exactly which areas they had difficulty with and could write the delays in an other