--- title: Acceptance and Commitment Therapy Intake Form Template | Paperform description: Professional ACT therapy intake form with psychological flexibility assessment, values clarification, and action planning. Perfect for mental health professionals and therapists using acceptance and commitment therapy. url: "https://paperform.co/templates/acceptance-and-commitment-therapy-act-intake-form" type: static generatedAt: "2026-04-04T00:43:05.141Z" --- [← Back to free form templates](/templates/) ![Acceptance and Commitment Therapy (ACT) Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/acceptance-and-commitment-therapy-act-intake-form.png) [Preview](https://_preview.paperform.co/ai-template/acceptance-and-commitment-therapy-act-intake-form) [Use this template for free](/create?ai-template=acceptance-and-commitment-therapy-act-intake-form) [Intake Forms](/templates/category/intake-forms/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Mental Health](/templates/industry/mental-health/) [Therapist](/templates/role/therapist/)[Counselor](/templates/role/counselor/)[Psychologist](/templates/role/psychologist/)[Social Worker](/templates/role/social-worker/) About this free form template ### Streamline Your ACT Therapy Practice with a Professional Intake Form Starting therapy can be transformative, but gathering the right information upfront is essential for effective treatment. This **Acceptance and Commitment Therapy (ACT) Intake Form** template helps mental health professionals, psychologists, and therapists collect comprehensive client information while introducing core ACT principles from the very first interaction. #### Why This Template Works for Mental Health Professionals Unlike generic therapy intake forms, this template is specifically designed for ACT practitioners. It combines standard clinical information with ACT-specific assessments including psychological flexibility measures, values clarification exercises, and committed action planning. This gives you a complete picture of your client's current struggles, core values, and readiness for change—all before the first session. The form walks clients through identifying experiential avoidance patterns, clarifying what truly matters to them, and beginning to think about concrete actions aligned with their values. This not only provides you with rich clinical data but also starts the therapeutic process immediately, helping clients engage with ACT concepts in a low-pressure way. #### Built for Therapists Who Value Efficiency and Client Experience Paperform makes it easy to create an intake experience that feels warm and professional, not clinical and overwhelming. With conditional logic, you can show follow-up questions only when relevant, keeping the form feeling conversational rather than exhausting. Add your practice branding, include calming imagery, and customize the success message to reassure clients that they've taken an important first step. Once submitted, responses flow directly into your practice management system, Google Sheets, or wherever you track client information. If you need clients to sign consent forms or treatment agreements, you can seamlessly connect this intake form to **[Papersign](https://papersign.com)** to collect legally binding eSignatures without switching platforms. For practices managing multiple therapists or locations, use **[Stepper](https://stepper.io)** to automatically route new intakes to the right clinician, send welcome emails with session scheduling links, update your CRM, and trigger appointment reminders—all without manual data entry. #### Perfect for Private Practices, Group Practices, and Telehealth Providers Whether you're a solo ACT therapist, part of a group practice, or offering telehealth services, this template adapts to your workflow. It's fully GDPR compliant and SOC 2 Type II certified, giving you and your clients peace of mind about data security. Embed it on your practice website, share it via a custom link, or add it to your client portal for a seamless onboarding experience. Get started with this ACT intake form template and spend less time on paperwork and more time doing the meaningful work that drew you to therapy in the first place. Built for growing businesses, trusted by bigger ones. 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