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Behavioral Health Intake Form

Asks about have you ever been diagnosed with a mental health condition, are you currently taking any medications for mental health, and have you experienced any of the following symptoms. Built for community mental health centers and behavioral health agencies.

Questions
8
Page
1
Time
about 2 min

Includes

  • E-signature
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Your practice

Live preview. Tap through it like a patient.

Who it is for

  • Community mental health centers and behavioral health agencies
  • Outpatient substance abuse and dual-diagnosis programs
  • Integrated behavioral health in primary care settings
  • Court-ordered and mandated behavioral health treatment

Formisoft for Mental Health

What's inside

  1. Full NameText · Required
  2. Date of BirthDate · Required
  3. Have you ever been diagnosed with a mental health condition?Long Text · Required
  4. Are you currently taking any medications for mental health?Long Text · Required
  5. Have you experienced any of the following symptoms?Checkbox · 6 choices · Required
  6. Do you have any history of substance use?Long Text
  7. Is there anything else you would like to discuss?Long Text
  8. SignatureE-Signature · Required

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Behavioral Health Intake Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

Related templates

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Questions

Formisoft provides secure form collection and a Business Associate Agreement (BAA). Your practice must review the form content, access permissions, and sharing workflow for its requirements.

Yes. You can add, remove, reorder, or reword any of the 8 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Patients open a secure link from an email, a text, or a QR code and complete the form on their phone, tablet, or computer before their appointment. No app download required.

Yes, on Front Desk. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Yes. The Behavioral Health Intake Form works on any device. Most patients complete intake forms on their phone, so every template is built for small screens first.

Send it before the visit, so patients arrive ready.

Add the Behavioral Health Intake Form to your account and make it yours in a few minutes.

Cancel anytime · BAA included

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