Updated
An ABA intake packet needs seven sections: client information, caregiver and contacts, insurance and funding, diagnosis and clinical history, goals and concerns, availability and logistics, and consents and policies. Keep it short enough to finish in 15–20 minutes on a phone, prefill anything the family already told you, and collect it with a HIPAA-compliant tool under a signed BAA.
A good intake form collects everything your clinical and billing teams need to start services — without exhausting a family that is already stretched thin. Most packets fail in one of two directions: so short that staff spend a week chasing missing details, or so long that parents abandon them halfway.
Here's what actually belongs in an ABA intake packet, section by section — and a free template you can adapt.
Child's legal name, date of birth, address, primary language, school/daycare placement.
Parent/guardian names, relationship, phone, email, preferred contact method and times, emergency contact.
Payer, member and group IDs, subscriber details, secondary coverage, and a photo of the card — enough to run verification without a follow-up call.
Diagnosis, date, diagnosing provider, and the report itself; current and past therapies (ABA, OT, speech); medications; medical conditions relevant to care.
What the family most wants help with, in their own words — behaviors of concern, safety issues, skills to build. This is clinical gold for the assessment.
Days and times the child is available, preferred setting (home, center, school), transportation constraints.
Consent to treat, HIPAA acknowledgment, release of information for records requests, financial policy, and cancellation policy — each a separate signature.
A 15-page packet emailed as an attachment gets printed, half-finished, and lost. Break it into short digital steps a parent can finish on a phone.
If the family gave a detail on the first call, it should be pre-filled in the packet. Every repeated question erodes trust.
Most incomplete packets just need a nudge. Automatic reminders at day 2 and day 5 recover a large share of stalled families.
Don't gate a first conversation behind the full packet. Qualify with five questions, then collect the rest while verification runs in parallel.
Digital, always — with paper as the exception for families who need it. Digital forms can be completed on a phone, validated as they're filled (no missing member IDs), fed straight into your systems without retyping, and chased automatically when they stall. Whatever tool you use, it must be HIPAA-compliant with a BAA — intake data is PHI from the first field.
The form is one step of a larger funnel — what happens around it (response speed, verification, reminders, scheduling) decides whether the family ever reaches a first session. Carelu turns the whole packet into a conversation: families answer naturally by chat, phone, or text; the record fills itself; and nothing is ever asked twice.
All seven sections, ready to print or rebuild in your forms tool. Free to adapt for your practice.
Long enough to cover the seven core sections, short enough to finish in 15–20 minutes on a phone. Anything the family already told you should be pre-filled.
Yes. Intake responses are PHI, so the collection tool needs HIPAA compliance and a signed BAA — a standard web-form builder without one doesn't qualify.
Yes — it's free to use and adapt. Have your compliance or legal reviewer confirm the consent language matches your state and payer requirements.
The seven sections still have to be collected. The four mistakes on this page are what Carelu takes away: no giant PDF, nothing asked twice, no packet left without a reminder, and no first conversation held back until the paperwork is done.
Your consent language stays yours, reviewed by your own compliance team, and your staff still review what comes in. The difference is that it arrives complete, signed, and filed.
Whatever the family told you by phone, chat or text is already on the form. They confirm it instead of typing it again.
A hosted intake built for a phone at 10pm. A family who stops halfway picks up where they left off, not at page one.
Consents, policies and releases are e-signed, and each signed document is generated as a PDF in the family’s packet the moment it is signed.
Families send the insurance card and diagnosis report by text or upload them on the form.
Follow-up flows nudge unfinished forms and missing documents until the family responds or opts out. Carelu is HIPAA compliant, SOC 2 Type II, and signs a BAA.
Forms that fill themselves.
Carelu collects the whole packet conversationally — phone, chat, or text — and never asks a family the same question twice.
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