Intake form template
- First month with the intake fee
- $540
- Ongoing monthly fee
- $480
- Deposit due at intake
- $270
Every figure on this page is computed from the inputs entered, by the method stated below it. OrderPadLedger publishes no tax rate, no screening rule and no survey: the defaults are a worked example to replace with your own.
The figures above start from a worked example ($540). Change any input and the answer updates as you type.
Download the Intake form template worked example (CSV)
This is a client intake form template that works the money a new client asks about at intake. Sessions or visits a month at your rate is the ongoing monthly fee; the one-off intake or assessment fee goes on top for the first month; and the deposit taken at intake is a share of that first month that you set. Every figure is yours; the form publishes no rate. Free, on the page, no account; the paid plan keeps every intake against the client.
Sessions times rate is the ongoing month
A practice, a coach or a service business bills by the session or the visit, and the ongoing monthly fee is the sessions a month at the rate. The form shows it on its own so the client sees what a normal month costs before the intake fee is added.
The intake fee on the first month only
An assessment, an onboarding or an intake fee is charged once, so it goes on the first month and not the ongoing figure. The form shows the first month with it and the ongoing month without, because a client who sees only the first figure thinks every month costs that.
The deposit at intake, as a share you set
Many intakes take a deposit to hold the first slot, as a share of the first month. The form takes the share and shows the deposit due at intake; the paid plan keeps the intake against the client with what was paid and the sessions booked.
Intake form template: common questions
Is this a free client intake form template?
Yes. Enter the sessions a month, your rate, the intake fee and the deposit share, and it works out the ongoing month, the first month and the deposit on the page with no account and no card. Print it as it stands. OrderPadLedger Pro adds your business name and keeps every intake against the client.
What else should a client intake form gather?
The client's details and contact, what they are coming for in their own words, how they heard of you, any consents your practice requires, and the money figures this form works. A regulated practice has intake requirements of its own, and those are your regulator's and your adviser's.
Should the intake fee be refundable?
That is your policy, and it should be on the form: whether the intake fee and the deposit are refundable, by when, and against what. The form works the figures; the paid plan prints your terms beneath them on every intake.
OrderPadLedger Pro
Keeping what you make
The forms are free forever. Pro turns them into the record: every order, application and intake filed against the customer it came from, your name and logo on the form, no watermark, and a clean export when the accountant or the applicant asks.
- Download as PDF
- No OrderPadLedger watermark
- Save every submission and reopen it later
- Your logo and business name on the form
- Export every submission in one go
- Order-received and intake reminders emailed to your customers
- Connect your own Stripe account and get paid online
- Connect your QuickBooks Online or Xero
$25per month, whole team
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Cite or embed this figure
Intake form template (First month with the intake fee): $540, OrderPadLedger, worked example.
Cite as: "Intake form template, OrderPadLedger", updated 2026-09-03, https://orderpadledger.com/tools/intake-form-template/.