Ontario psychotherapy client intake checklist

What intake forms do Ontario psychotherapists need for new clients?

Typically biopsychosocial history, risk screening, informed consent, insurance or EAP details, and telehealth consent when applicable. Here is the full operational checklist:

We'll email you the one-page PDF you can use as a starter for your practice.

Checklist items

1. Contact information and emergency contact
2. Presenting problem / reason for referral
3. Biopsychosocial history questionnaire
4. Prior mental health treatment history
5. Current medications
6. Risk screening (self-harm, harm to others, substance use)
7. Informed consent for psychotherapy (limits of confidentiality, fees, cancellation)
8. Telepsychotherapy consent (if virtual)
9. Extended health insurance policy details and session limits
10. Insurance card copy (if billing benefits)
11. EAP referral letter and session authorization (if applicable)
12. Fee agreement / OOP receipt preferences
13. Custodian acknowledgement (group practice)
14. Minor client — guardian consent and capacity documentation (if applicable)

Checklist for operational use. Verify requirements with CRPO standards, your insurer, and current PHIPA guidance.

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