Intake Assessment Form

Intake Assessment Form Template for England and Wales

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Key Requirements PROMPT example:

I need an Intake Assessment Form for my mental health clinic that includes detailed risk assessment sections and cultural considerations, ensuring compliance with NHS standards and GDPR requirements for implementation by March 2025.

What is a Intake Assessment Form?

The Intake Assessment Form is a crucial document used across various service sectors in England and Wales to systematically collect and record information about new clients or service users. It serves as the primary tool for initial assessment and forms the foundation for service provision planning. The form must comply with UK GDPR, the Data Protection Act 2018, and sector-specific regulations. It typically includes sections for personal information, needs assessment, risk evaluation, and consent declarations. Organizations use this document to ensure consistent data collection, maintain legal compliance, and facilitate appropriate service delivery.

What sections should be included in a Intake Assessment Form?

1. Personal Information: Basic demographic data, contact details, and identifiers including name, date of birth, address, phone, email

2. Emergency Contacts: Next of kin and alternative contact information including relationship, contact details and access permissions

3. Consent Declaration: Data processing and information sharing permissions, including GDPR compliance statements and opt-in/opt-out choices

4. Primary Assessment Areas: Core evaluation criteria relevant to service provision, including presenting needs, current situation, and support requirements

5. Risk Assessment: Initial evaluation of key risks and safety concerns, including immediate safeguarding needs and risk mitigation strategies

What sections are optional to include in a Intake Assessment Form?

1. Medical History: Detailed health information including current conditions, medications, allergies, and previous treatments - used in healthcare settings

2. Safeguarding Concerns: Additional protection needs assessment including vulnerability factors and specific safeguarding measures required

3. Cultural/Religious Requirements: Specific cultural or religious considerations that may impact service delivery or support arrangements

What schedules should be included in a Intake Assessment Form?

1. Privacy Notice: Detailed information about data processing, storage, sharing, and individual rights under GDPR

2. Service-Specific Assessments: Additional specialized assessment tools and criteria specific to particular service areas

3. Consent Forms: Supplementary consent documentation for specific services or information sharing arrangements

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare
Social Services
Mental Health Services
Educational Institutions
Professional Services

Relevant Teams

Intake and Assessment
Clinical Operations
Administration
Quality Assurance
Client Services

Relevant Roles

Intake Coordinator
Case Manager
Social Worker
Healthcare Administrator
Clinical Director
Service Manager
Compliance Officer

Find the exact document you need

Medical Intake Form

A standardized template for collecting patient information in England and Wales, compliant with UK healthcare and data protection regulations.

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Let's create your Intake Assessment Form

What is a Intake Assessment Form?

What sections should be included in a Intake Assessment Form?

What sections are optional to include in a Intake Assessment Form?

What schedules should be included in a Intake Assessment Form?

Authors

Alex Denne

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