This anxiety disorder diagnostic assessment form is built for therapists, counselors, psychologists, and other mental health clinicians who need a clear way to collect screening information before or during intake. It covers core identifying details along with symptom duration, referral information, prior diagnoses, and current treatment so clinicians can review a more complete picture before the appointment.
The template also includes focused questions about panic attacks, including whether they occur and how often. That makes it useful for practices that want to document both general anxiety concerns and more specific symptoms such as acute episodes of fear, avoidance patterns, and related functional impact.
As a client intake form or patient intake form, this template gives providers a practical starting point for mental health assessments while leaving room to tailor questions to a specific specialty, population, or workflow. It can be adapted for private practices, group clinics, and referral-based settings that need organized, consistent intake information.
