Couples Therapy Intake Form
A professional couples therapy intake form for Swiss practices. Each partner completes their own section covering relationship history, individual perspective, goals and prior therapy.
About this template
The Couples Therapy Intake Form is designed for Swiss psychotherapy and counselling practices that work with couples. Each partner completes the form independently, ensuring that both voices are heard before the first session. The form captures relationship history, each person's individual perspective on current difficulties, shared and individual goals, prior therapy experience, and any concerns about the process.
What this form collects
- Personal contact details for each partner
- Relationship history and current living situation
- Individual description of the presenting concern
- Personal therapy goals and expectations
- Prior individual or couples therapy history
- Relevant health or medication information
- Availability and preferred session format
- Informed consent and confidentiality acknowledgement
Confidentiality under Swiss law
Psychotherapists in Switzerland are bound by professional secrecy under Art. 321 StGB. All information disclosed in this form is strictly confidential and processed in accordance with the Swiss nFADP (revised Federal Act on Data Protection).
How to use this template
Use this template
Click 'Use template' to create a copy in your dashboard.
Customise for your practice
Add your practice name, logo and any additional intake questions specific to your approach.
Send to each partner separately
Share the unique form link with each partner so they can complete it independently and in confidence.
Review before the first session
Read both submissions before the first meeting to prepare a tailored session plan.
Couples therapy intake in Switzerland: a practical guide
Couples therapy is a structured psychotherapeutic intervention that helps partners understand relational patterns, communicate more effectively, and work through conflict. Whether the couple is navigating a specific crisis or seeking preventive support, a thorough intake process lays the groundwork for productive therapeutic work.
Why a separate intake form for each partner?
In joint intake appointments, one partner may dominate the narrative or moderate their answers to avoid conflict. By asking each partner to complete an independent written form, the therapist gains unfiltered access to two distinct perspectives. This also allows each person to disclose sensitive matters — previous affairs, mental health diagnoses, or personal goals — that they might not raise in the presence of their partner at the outset.
Key areas covered in a Swiss couples therapy intake
A comprehensive intake form for couples in Switzerland typically addresses: the duration and nature of the relationship; the living situation; the presenting concern as seen by each partner individually; the history of previous therapy; any current mental health treatment or medication; and the goals each person brings to the process.
Data protection and professional secrecy
Swiss psychotherapists are subject to the strictest confidentiality obligations in the health professions. Art. 321 of the Swiss Criminal Code makes it a criminal offence to disclose information shared in a therapeutic relationship without the client's consent. The revised nFADP requires that all personal data is processed lawfully, proportionately, and with appropriate security measures.
What happens after the intake form is submitted?
After both partners have submitted their forms, the therapist reviews the responses and identifies areas of convergence and divergence. This preparation enables the first session to move quickly into substantive work rather than basic information gathering.
Frequently asked questions
Can one partner complete the form on behalf of both?
No. Both partners should complete the form independently. The value of the intake process lies precisely in capturing two separate perspectives without influence from the other partner.
Is the information shared between the partners?
Information submitted in each partner's individual intake form is treated confidentially by the therapist. The therapist will not share the contents of one partner's form with the other without explicit consent.
What if we are already separated?
Couples therapy can be appropriate for separating or recently separated couples, particularly where children are involved and co-parenting communication needs to be supported. The intake form includes a field for current living situation so the therapist can adapt the approach accordingly.