Form templates / Mental Health & Therapy
Therapist Contact Form
A therapist contact form should ask for as little as possible. Someone reaching out for the first time needs a low doorstep, not an intake questionnaire.
For therapists, counsellors and mental-health practices.
The shortest form you'll ever build
The person filling this in has often been drafting the message in their head for weeks. Every additional field is another reason to leave it until next month, and the ones who leave are the ones who most needed to send it.
So this is five questions: who you are, how to reach you safely, roughly what it's about, and when you're free. The clinical detail belongs in an intake form after contact is made - not between someone and their first message.
Better than publishing your email address
A mailto link gets you spam and messages with no context. A form gets you the same enquiry with the details you need, in a list you can search, and no address for a scraper to harvest.
Ask gently, and hold it carefully
A first contact form in this field is often written by someone who has been putting it off for months. Short, plain and unintimidating matters more than thorough - you can ask the rest once there's a relationship.
What it must not do is feel surveilled. These pages carry no analytics, no third-party scripts and no cookie banner, and responses go only to the address you nominate.
Nothing to consent to
No analytics, no third-party scripts, no cookie banner - so the page that asks people to trust you with a message isn't also asking them to accept trackers.
Yours to change, immediately
Nothing here is fixed. Rewrite a question, reorder them by dragging, add your brand colour, delete half of it. Save and the live form updates - there's no separate publish step and no deploy to wait for.
What this template asks
- Your name
- Email address
- Phone number
- How would you prefer to be contacted?
- Is it okay to leave a voicemail?
- Broadly, what would you like help with?
- Anything you'd like me to know?
- Have you had therapy before?
- How would you like to meet?
- When are you usually free?
- How would you be paying?
More Mental Health & Therapy forms
Questions
Should I ask what the problem is?
One broad question is enough, with an option to say nothing. Some people need to write it all out; others can't yet, and forcing them loses the enquiry.
How private is this?
Pages are encrypted in transit, responses go only to you, and these pages carry no analytics, cookies or third-party scripts of any kind - so nothing is recording that someone visited.
Will I get spam?
Far less than a published email address. Every form carries a hidden trap field that automated submitters fill in and humans never see, and those submissions are silently discarded.
Can I send messages to a shared inbox?
Yes. Notifications go to a list of addresses you choose, so a team alias works as well as one person.
Can I add this to my website?
Link to it from anywhere - a button, a nav item, a footer. It's a normal page with its own URL, so no embedding or code is required.
Is this confidential enough for therapy enquiries?
Pages are encrypted in transit and responses stay in your account, going only to the recipients you choose. Keep the form to what you need to make contact, say clearly that it is not for emergencies and where to go instead, and check your professional body's guidance on electronic records.
Publish your therapist contact form today
Start from this template and change anything you like. Free to begin.