Couples therapy intake template - Notion + PDF (HIPAA-aware setup)

Last updated: May 2026 - Wren, keeper of the drawer

A couples therapy intake template is a structured questionnaire that collects relationship history, presenting concerns, prior treatment, individual mental health, attachment and communication patterns, and goals for therapy from each partner separately before the first session. Most therapists need one because the alternative - reconstructing two life histories live in session one - burns 50 to 90 minutes that could have been used for actual joining and contracting. This guide walks through what belongs in a good couples intake, why partners fill it out independently, how to set the whole thing up in Notion + PDF in a HIPAA-aware way, and where Template Drawer's couples therapy intake template fits against SimplePractice, TherapyNotes, Jotform clinical, and Etsy intake PDFs.

What's in a good couples intake

The shape of a couples intake is fairly settled across modalities. Whether you trained EFT with Sue Johnson, Gottman Method, Integrative Behavioral Couple Therapy, PACT, IFIO, or a homegrown integration, the same eight sections show up in 95% of intakes I've seen across the practices that buy this template.

1. Relationship history. How they met, length of relationship, marital or partnership status, cohabitation history, prior marriages, blended family structure, children (biological, step, adopted, planned, lost), pets, household composition. Dates matter. Vague "we've been together a while" answers become a session-one problem.
2. Presenting concerns. Each partner's presenting concerns in their own words, the precipitating event that prompted the call now (almost always there is one), what each partner hopes therapy will change, and the 0-10 distress rating for the relationship overall.
3. Prior therapy attempts. Individual therapy histories, prior couples therapy (with whom, for how long, what helped, what didn't, why they stopped), prior assessments, medications, hospitalizations relevant to current functioning. The line "we tried couples therapy and it made things worse" is data, not a complaint - find out why.
4. Individual mental health history. Each partner's mental health history separately: current diagnoses, current medications, substance use, trauma history (with a screening question, not a deep dive), self-harm or suicidal ideation history with current risk, eating-disorder history. This is the section where the PDF version matters most - some of this should not live in Notion.
5. Attachment patterns. If you're EFT-trained, this is where the cycle starts to surface. Pursue / withdraw, attack / defend, both-withdraw freeze, anxious / avoidant patterns. Ask about each partner's family-of-origin attachment figures briefly. A four-question screen here is enough at intake.
6. Communication patterns. If you're Gottman-trained, this is where the Four Horsemen show up. Criticism, contempt, defensiveness, stonewalling - frequency and which partner does which. Also: conflict frequency, conflict topics (money, in-laws, parenting, sex, division of labor, work-life balance), and what de-escalation has historically looked like.
7. Sexual and intimacy concerns. Frequency, satisfaction, discrepancies, pain, dysfunction, infidelity (current and historical), pornography or solo-sex friction, sexting or affair history. This section often gets skipped in intake and surfaces in session four. Asking up front normalizes it.
8. Goals for therapy. What each partner wants this work to produce. "Decide whether to stay or go" is a different contract from "rebuild after the affair" is a different contract from "stop fighting about the kids." Get the goal in writing in session one or you'll drift.

You can swap the framing on sections 5 and 6 depending on orientation. EFT therapists will lean on the attachment-cycle questions. Gottman therapists may add a Sound Relationship House screening. IFS-trained couples therapists may ask each partner to name the "part" that shows up during conflict. The skeleton holds; the language flexes.

The "both partners separately" rule

Each partner fills out their intake independently, on their own device, in their own time. Not at the kitchen table together. Not over the shoulder. Not "we did it as a couple, here's the joint answers." Separate.

This matters for three reasons. First, honest answers. A partner sitting next to the other partner will under-report dissatisfaction, infidelity, substance use, self-harm history, and ambivalence about the relationship. The intake is also functioning as a brief individual assessment for each partner, and that requires privacy. Second, you need to see the discrepancy. When one partner rates the relationship a 7 and the other rates it a 3, that gap is the most important thing on the form. If they fill it out together, you lose the gap. Third, your therapeutic stance. If you're going to hold both partners' truths without taking sides, you need to know what each partner actually thinks before they walk in. Joint disclosure is a session, not a form.

The mechanics: send each partner a unique link or PDF, ask them to complete it at least 48 hours before session one, and do not show one partner's answers to the other unless and until clinical reasons make it appropriate. The synthesis sheet you build (see below) is for your eyes only - it lives behind your own login, not in a shared workspace. Practical script for the email confirmation: "Each of you will receive a separate intake form. Please complete yours on your own, without your partner present, and don't share your answers with each other before our first session. What you write is confidential to me, not to your partner."

Notion setup walkthrough

The Template Drawer couples intake template is built around three core databases plus a per-couple page template. Here's the structure, with the caveat that anything containing PHI should only live in a Notion Enterprise workspace with a BAA - or stay in the PDF version on your own HIPAA-compliant storage.

Three databases

• Couples - one row per couple. Properties: Couple ID (initials or pseudonym), Status (waitlist / active / paused / terminated / referred out), First contact date, Source, Fee, Sliding scale flag, Insurance flag, Diagnosis (if any) for billing, Linked Sessions, Linked Intakes.
• Sessions - one row per session. Properties: Couple (relation to Couples), Session number, Date, Modality (in-person / telehealth), Attendees (both / partner A / partner B), Focus, Homework assigned, Homework reviewed, Next-session prep, CPT code if billing.
• Intake Responses - one row per partner per intake (so two rows per couple at first intake). Properties: Couple, Partner identifier (A or B - no real names if you can avoid it), Intake date, Status (sent / partial / complete / reviewed), and a Notion-page body that holds the answers.

The intake page template

Each intake response is its own Notion page using the same template: the eight sections above, each as a heading with a toggle-block "for therapist eyes only" sub-section underneath. Partners see the questions and answer fields. You see your private notes underneath. The page is linkable - you share the URL with one partner only, and they fill it out in their browser. (Reminder: this is only HIPAA-defensible on Notion Enterprise with a BAA. On standard Notion, send the PDF instead.)

The therapist synthesis page

For each couple you build a synthesis page that pulls both partners' intakes into one view. The synthesis has five blocks: the cycle (EFT) or the Four Horsemen map (Gottman) or the parts map (IFS) - whichever you use; the discrepancy block (where do their answers diverge most sharply); the risk block (any disclosures that change your safety planning, including DV screening flags); the contract block (what you'll propose for sessions 1-3); and the strengths block (because every couple has them and you'll need them on day one).

Session 1-3 prep workflow

The template ships with three pre-built session prep pages. Session 1 is joining, contracting, and reflecting back the synthesis - "Here's what I heard from each of you, here's the cycle I see, here's what I'd suggest we work on." Session 2 is the individual sessions (one with each partner, 30 minutes each or a full session each, your call) where you get the answers they couldn't write down. Session 3 is the joint contract - goal, frequency, modality, fee, between-session homework, and the criteria for assessing whether this work is helping in 8-12 weeks. Each prep page links to the relevant intake responses and to the Session database row.

PDF version - for HIPAA-cautious therapists

If you don't want PHI in Notion at all - and many therapists rightly don't - the template ships with a fillable PDF intake that mirrors the Notion structure exactly. Each partner gets the PDF, fills it on their device, and returns it through your existing HIPAA-compliant channel: the secure-message feature in SimplePractice, TherapyNotes, Jane App, or whichever EMR you use; a HIPAA-compliant document-sharing service like Hushmail, Paubox, or a Citrix ShareFile workspace; or a client portal you've set up specifically for this.

You keep the PDFs in your EMR or document store. On the Notion side, you transcribe only your synthesis notes - the cycle, the discrepancy summary, the contract, the strengths, your prep for sessions 1-3 - in a form that does not include identifying detail. Partner A and Partner B, not Maria and Tomas. Cycle name and clinical impression, not verbatim disclosures. This setup keeps Notion as the workflow brain and your EMR as the PHI vault, which is how most of the therapists we work with prefer to run it.

Pricing for therapy templates - the awkward bit

Honest talk: therapy-template pricing is weird, and I'm not going to pretend €99 is the obvious right number when free options exist.

If you already pay for SimplePractice ($39-$99/month depending on tier), you get an intake-form builder included. It's HIPAA-compliant out of the box. It's also fairly rigid - you can add questions, but the layout, logic, and synthesis are limited, and there's no therapist-side workflow page that ties sessions 1-3 prep together. If your needs are straightforward and you live inside SimplePractice anyway, use what you've already paid for.

TherapyNotes ($59-$69/month) is similar - intake forms included, HIPAA-compliant, less design flexibility than you'd want for a couples-specific workflow but enough for most solo practices.

Jotform clinical templates are free to $39/month and offer signed HIPAA BAAs on Gold and above. Their couples-intake templates are usable but generic - built for general counseling, not couples specifically. Customization is possible but you're rebuilding it.

On Etsy, intake-as-PDF couples templates run $15-$40. Most are competent. None come with a Notion workspace, a therapist-side synthesis sheet, a three-session prep workflow, or a walkthrough.

Template Drawer's couples intake template is €99 Pro. It is not the cheapest thing on this page. What it includes that the others don't: a complete Notion workspace with three linked databases, partner-separate intake page templates, a therapist synthesis page, three pre-built session prep pages, a fillable PDF mirror for HIPAA-cautious setups, a Loom walkthrough where I show the build live, and 30-day refund if it doesn't fit your practice. If you want HIPAA-compliant out of the box, you want SimplePractice or TherapyNotes. If you want a flexible Notion-native couples workflow that bolts cleanly onto whatever EMR you already use, this is the one I'd buy.

Comparison

Get the template

The Couples therapy intake template - Notion + PDF (C1-02) is €99 Pro tier. You get the Notion workspace (Couples, Sessions, Intake Responses databases, intake page template, therapist synthesis page, three session-prep pages), the fillable PDF intake mirror, a Loom walkthrough where I show you the workspace live and explain the design choices, a written setup guide for the HIPAA-aware configurations, and a 30-day refund window. If you decide in week three it isn't the right shape for your practice, you email me and you get your money back. No script, no hoops.

Browse the rest of the coaches and therapists collection if you want the session-prep tracker, homework menu, or termination-letter templates separately. Founding patrons get all current and future Template Drawer products at a fixed lifetime price - details on the founding patron page.

FAQ

Is Notion HIPAA-compliant for couples therapy intake?

Standard Notion is not. Notion Enterprise offers a signed BAA, which makes it HIPAA-compliant for covered entities that configure access correctly. If you're on the Plus or Business tier, you should not store PHI in Notion. Use the PDF version on your HIPAA-compliant document store (EMR, secure portal) and keep only de-identified synthesis notes in Notion. None of this is legal advice - confirm with your malpractice carrier and your attorney.

Should partners fill out the intake together or separately?

Separately. Each partner completes their intake on their own device, without the other present, before session one. Filling out together loses the discrepancy data that's most useful for case formulation, and partners under-report dissatisfaction, infidelity, substance use, and ambivalence when their partner can see the answers.

What's the difference between a Gottman intake and an EFT intake?

A Gottman intake leans on the Sound Relationship House model - friendship, conflict management, shared meaning - and screens for the Four Horsemen (criticism, contempt, defensiveness, stonewalling) plus repair attempts. An EFT (Emotionally Focused Therapy) intake leans on attachment theory, asking about each partner's primary emotion underneath the conflict cycle and mapping the pursue-withdraw or attack-defend pattern. The Template Drawer intake covers both because most therapists draw on both. You adapt the wording to your orientation.

Can I customize this template for my own theoretical orientation?

Yes. The Notion workspace is fully editable - rename sections, rewrite questions, add modality-specific screens (PACT secure-functioning, IFIO parts mapping, Imago dialogue cues), remove what you don't use. The PDF version is editable in Acrobat Pro or similar. The structural skeleton is designed to flex.

What if my client doesn't use Notion?

Use the fillable PDF instead. Most clients prefer it - no account creation, no login, just open and type. You receive it back through your secure-message portal in your EMR. Notion stays therapist-side as your workflow brain. The template ships with both so you can mix and match per couple.

Does this come with consent forms or informed consent?

No. Informed consent documents are jurisdiction-specific, license-specific, and modality-specific, and they need to be drafted or vetted by an attorney familiar with your state or country's mental-health practice law. We do not provide consent forms or treatment agreements - your malpractice carrier or professional association usually has templates that have been legally reviewed for your jurisdiction.

Can I use this template with non-couple clients (individual, family)?

It's designed for couples and the synthesis logic assumes two intakes per case. For individual clients, you'd be deleting the dyad structure - at which point you're better off with the individual intake template in the same collection. For family work, the three-database structure can extend (Family + Members + Sessions) but it's not built for that out of the box. If you want a family-tailored build, ping us.

Is there a CPT-code billing helper?

The Sessions database has a CPT code property for tracking, but this template is not a billing tool. It does not generate superbills, file claims, or check eligibility. For US insurance billing, you want SimplePractice, TherapyNotes, or a dedicated billing service. The template is workflow-side: prep, notes, homework, synthesis. Billing stays in your EMR.

Are these forms legal in my state or country?

The intake questions themselves are clinical, not legal documents, and don't carry jurisdiction-specific requirements. Where jurisdiction matters is in informed consent, mandated reporting language, telehealth-specific disclosures, and record-retention practices - none of which this template provides. Your license board, your malpractice carrier, and your attorney decide what your full intake packet must include in your jurisdiction. This template is one part of that packet, not all of it.

If you build something better on top of this, I want to see it. Send screenshots and I'll add a credit when we publish the next iteration.

Wren - keeper of the drawer.