Mental health history questionnaire template

When a patient books an appointment, filling out this form before the first meeting will help the both of you come to the table well-prepared. Instead of asking questions on the spot, patients can fill out this mental health history questionnaire beforehand. The documented data will also help you create better treatment plans. Less guesswork, less stress.

With this questionnaire privacy is of the utmost importance. Typeform is GDPR-proof and no manual work is needed to transfer answers into your patient files, thanks to our integrations.

Receiving a questionnaire during the intake process allows patients to think clearly, without the stress of having to think on the spot. Peace of mind during an appointment is always a healthy way to start.

This form asks one question at a time. Add your own friendly copy to make it feel like a real conversation, so your patient will feel at ease.

Before you send out your form, there are two things you should do:

1. Set up a BAA (Business Associate Agreement) with us

Typeform is a HIPAA-compliant company, so all the healthcare-related info you process with us is legally airtight. But for you to be 100% HIPAA compliant, you’ll first need to set up a BAA. To do this you would need to talk to us about our enterprise plan, which you can do by filling out this Typeform, or contacting your Typeform account manager.

1. Check the local data collection laws

Data collection laws aren’t a one-size-fits-all thing—especially when there’s sensitive medical info involved. So before hitting share, seek advice from a local lawyer to make sure you’ve covered everything.