Confidential Patient Intake Form: Fill & Download for Free

Interesting question. One I have thought about before. One of the most important ethical things is patient confidentiality. But another important thing is to not be alone to figure it all out when you’re just learning.When I started healing, I worked in a big clinic. Lots of healers, lots of patients. Sometimes the chairs on all the walls were full of people waiting. And we’d have at least four healing stations going at a time. Newer healers would b partnered with experienced healers so they could be supervised, guided and mentored.After we closed, we’d have a meeting where we discussed our cases, to share information, insight, and to give/get advice. I felt pretty uncomfortable with this part. Even though in aclinic format, there is no privacy, I felt like we were violating confidentiality anyway.When I started my own clinic, I decided to do things slightly differently.First of all, my clinic is tiny. 1, maybe 2 stations, max. Only enough room for a handful of people to be waiting inside. I also only tend to have one or two other healers on any given day. We don’t do meetings to discuss things. Have a problem or question? Ask it right away. In front of the patient. That way it isn’t like gossiping, but like consulting.Once in a while we do need to make others aware of something about someone. We don’t keep comprehensive files there- just first name and very basic info. (The proper intake forms were way too involved and freaked people out who couldn’t read well or who didn’t have an address.) And many times people don’t tell you what the actual problem is. I have one guy who comes regularly. He’ll say something like he has a cold. I ask him how his hearing is lately. That’s code for “are you still experiencing auditory hallucinations?” I’m not sure if he knows I know that’s what he means when he complains about his hearing, and no one who hasn’t worked with him would know, so if I have another healer with me, I have to tell them so he gets treated properly.Once or twice I’ve had a case I needed to ask a master healer about. Someone not getting well in the time I thought they should. In that case, I either ask the patient if they mind if I consult someone else, or I don’t use any identifying information for them when I ask the master. Just initials, no personal info except what I’m asking about.Sorry to blab on. Ask your therapist. They may need advice. They may have to report. You can let them know what you are comfortable with them sharing or not.

You cannot and will never be able to for many clients.Therapy is so unregulated and still experimenting. I do not blame the therapist for doing a well-intentioned session fully discussed and agreed upon with the client. I am a rational person who understands that unpredictable things can happen no matter how well planned. I can get over those accidental unforeseen events and I agreed fully knowing it could go sideways (not a lot of clients have that self awareness). I take responsibility for my part in agreeing to something I believed could have helped. After a session like this…..I left and refused to come back for 2 months…..not because of the therapist …..because neither one of us knew how intense the reaction would be to the therapy.Then there are the therapists that say things like…..“Trust the girl in your process group who has broken confidentiality agreements and steals traumas she hears about and claims them as having happened to her”.i responded by asking the nurse to give the girl her newborn baby for the afternoon and let her go play down by the river….I put trust in perspective for her“What holes were penetrated during the assault”?I cried and asked why do you need to know that….he didn’t need to know that and he got talked to about asking me that question…his defense was he needed to check a box on an intake form.“We have had success with co gender and co age patients with psychiatric disorders during inpatient treatment”.This was said after I revealed I was put in at 16 into an adult psychiatric inpatient unit with adult male pedophiles that shared a door to my room….I hadn’t even told them what the one guy did to me.When patients who are already confused and damaged have to go through a bunch of professionals that further damage them, the professionals need to figure out some rules and regulations. Otherwise, how can any professionals be certain about not causing further trauma.You can be a great therapist and still hurt me accidentally. You can be a terrible therapist and hurt me with careless interrogations. You can be a terrible therapist and put me in reach of pedophiles. Therapists have a lot of power to exacerbate situations.Therapy is not the answer for me. No therapist out there can help me anymore. We could have a nice chat about life but I am not capable of trusting another therapist to “help” me.

It depends on the psychiatrist. Every one seems to have their own preferences when it comes to seeing a patient and what setting they’re in, as well.For a first session—the typical session in the U.S. goes a little like this:Paperwork, payment arrangements. Filling out tedious paperwork and paying your co-pay or whatever you owe for the session. If you have insurance, it will be your specialist co-pay.Going over informed consent and the limits of confidentiality. Your doctor will have given you some forms explaining when they have a duty to break confidentiality in order to save a life, including yours. Some will go over this with you verbally during the introduction to your session, and some expect you to read it on your form and sign it. There are risks and benefits to your treatment that should be detailed on your informed consent forms. They may go over that with you, too.Medical and psychiatric history intake. This is where your doc will ask you what brought you to their office today, and if there’s any history of mental illness in your family. They’ll also ask about your medical history and your family’s medical history because that will affect what they may prescribe for you.Symptom overview. You’ll talk about your symptoms and what’s been bothering you. Your doc will ask questions related to your symptoms and take note of any signs of disorders that you might have.Possible prescriptions and patient education. The doc will recommend a course of treatment and possibly talk therapy and medication. They will write you a prescription if needed and answer any questions that you have about the session or the medication.That’s it, you’re done, and you can go merrily on your way.Good luck.