A psychiatry intake form built around what has already been tried

A psychiatric intake form that respects the first appointment

A first psychiatric appointment is short and there is a great deal to cover. Spending twenty minutes of it establishing which medications have already been tried, at what doses, and what happened is a poor use of the time — particularly when the patient could have written it down at home with the bottles in front of them. This preset is a new patient psychiatric intake built around exactly that: what has been tried, what helped, what did not, and what the patient is taking now. Everything is editable, the PDF is available immediately, and there is no signup and no email wall between you and a document you are about to hand to somebody who is already anxious about being here.

• Built for HIPAA-compliant workflows

• Free to start — 50 patient actions each month

What a psychiatry patient history usually needs to capture

Presenting concerns in the patient's own words, with room to write properly. Then the medication history that makes this form worth its length: current psychiatric medications with dose and how long they have been taken, previous medications with the response and any side effects, and non-psychiatric medications and supplements alongside. Previous treatment — hospital admissions, therapy, previous prescribers, and what the patient found helpful. Relevant medical history including thyroid conditions, head injury, seizures and pregnancy status. Substance use where your practice asks about it. Family psychiatric history. Sleep, appetite and daily functioning. Support network and living situation. Emergency contact, current providers, and practice policies with a signature. The preset opens with a conservative version of all of this, and sensitive modules are optional rather than switched on by default.

No scoring, no scales, no risk assessment

This matters enough to state plainly rather than bury in a footnote. The form collects what the patient chooses to report and stops there. It does not score answers, calculate anything, contain a diagnostic or screening instrument, assess suicide or self-harm risk, triage urgency, suggest a diagnosis, or comment on whether a medication is appropriate. Those are the work of a psychiatrist with the patient in front of them, and no intake document — however well built — should sit between a clinician and that judgement. Safety and crisis information is a section your practice writes and owns, with the wording, contacts and escalation steps your setting and jurisdiction require. The preset leaves a place for it rather than putting words in your mouth, because the right words depend on your practice and cannot be supplied by a template.

Sensitive by nature, so minimal by default

A psychiatric history is among the most sensitive documents a practice holds, which shapes how this preset is built. Optional modules covering substance use, trauma history and sexual health are available but switched off unless you turn them on, so your practice decides what it needs rather than inheriting somebody else's questionnaire. Questions are worded to invite what the patient wants to share rather than to interrogate. And because it is a public builder, nothing you type here is sent to analytics and you should build the blank form here rather than entering real patient information. If your practice keeps psychotherapy notes, remember those are generally handled separately from the rest of the record and are not what this form collects.

A two-psychiatrist practice, one afternoon

A practice with two psychiatrists and a nurse practitioner starts from this preset. The lead psychiatrist expands the previous medication section into a proper repeating table with dose, duration, response and reason for stopping, because that single section saves her the most time in a first appointment. She turns on the substance use module and leaves trauma history off, judging it better explored in conversation than on paper. She rewrites the presenting concerns prompt into something warmer after reading it aloud. She writes the practice's own crisis section, listing their after-hours arrangement and the local crisis line. Their attorney reviews the confidentiality and policy wording for their state. One afternoon, and first appointments start twenty minutes further along.

Who owns what, and where this goes next

The psychiatrist owns every clinical judgement this form deliberately avoids making, and should review the questions so they match how the practice actually assesses patients. Your attorney or compliance lead should review confidentiality, consent and policy wording, which varies by state and by licence. This is an original document rather than a copy of any published instrument or questionnaire, and if your practice uses validated scales they remain separate documents administered under your own clinical governance. DocRepute is HIPAA-focused and built for HIPAA-compliant workflows, though no form alone makes a practice compliant. When you would rather patients completed this at home, unhurried, with their medication bottles to hand, the same preset drives DocRepute digital patient intake — which for this form in particular tends to produce noticeably fuller answers than a clipboard in a waiting room ever will.