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> Client Intake Checklist
Client Intake Checklist
1. Initial Contact Information
2. Basic Demographic Information
Record date of birth
Note gender
Gather address details
Inquire about preferred language
3. Referral Information
Identify how the client heard about your services
Record the name of the referring individual or organization
4. Service Needs Assessment
Discuss the specific services the client is seeking
Identify any immediate concerns or issues
Assess urgency of the client’s needs
5. Financial Information
Inquire about insurance coverage, if applicable
Discuss payment methods and options
Confirm any financial assistance needs
6. Consent and Privacy
Explain confidentiality policies
Obtain consent for treatment/services
Discuss data protection and client rights
7. Scheduling
Determine preferred dates and times for appointments
Confirm availability of services
Schedule the initial appointment
8. Follow-Up Actions
Provide the client with a summary of the intake discussion
Send appointment confirmation via preferred communication method
Outline any required documents or information for the first appointment
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