Accessible intake
and consent.
Can this person get through the door: the first email, the forms, the first session?
Practical adjustments to first contact, paperwork and consent, so that disabled clients don’t have to fight for access before therapy has even begun.
What this is: a practical guide to accessible first contact, forms and consent, with optional intake questions.
Why it matters: barriers at intake can stop people starting therapy, or teach them their needs are a nuisance.
The sharpest reframe: access is part of the therapy, not admin around it.
One thing to take away: ask one open access question at first contact.
The short version
Access starts before the first session: with how people can contact you, what your forms ask and in what format, and how consent is explained. Asking about access early, in plain language and without asking for reasons, saves clients from having to fight for basics later. Consent should be accessible, ongoing and the client’s own, with disability never treated as a reason in itself to doubt capacity.
First contact
Practice- Offer more than one way to get in touch: email, text, phone, a web form, and video relay where available.
- Say on your website that you welcome access requests, and how to make one.
- Explain in plain language what happens after someone gets in touch, and how long a reply usually takes.
- Describe your premises honestly: steps, lifts, toilets, parking, distance from public transport, noise. Photos help.
- Make online therapy an option, not a lesser alternative. See Online Therapy as Access.
Ask about access early
A single, open question at first contact helps many people. For example:
“Is there anything that would make contacting me, or coming to sessions, easier for you? For example the format, timing, communication or the room. You don’t need to give a reason, and you can tell me later if things change.”
A fuller set of optional questions is below and as a Word download. Don’t make them compulsory, and don’t ask for diagnosis as a condition of adjustments.
Download intake access questions (.docx)Contact
- How would you prefer to be contacted: email, text, phone, video call, or something else?
- Is there a time of day that is better or worse for you?
Format and timing
- Would you prefer to meet online, by phone, or in person?
- Would a different session length, or breaks during sessions, help?
- Is there a day or time that tends to suit your energy best?
- If your health means you sometimes can’t make a session, what would help? For example, switching to online on the day.
Communication
- Is there anything that helps you communicate, or helps you understand me? For example, captions, an interpreter, written summaries, extra time, or using text.
- Would it help to have information in a different format, such as large print, plain text, Easy Read or audio?
The room or setting
- If we meet in person, is there anything about the building, room, seating, lighting, noise or smell I should know about?
- If we meet online, is there anything about video, sound or the camera that would make it easier?
In sessions
- Is there anything that helps you feel comfortable, such as moving, stimming, looking away, or taking breaks?
- Is there anything you would prefer I didn’t ask you to do, such as closing your eyes, certain exercises, or eye contact?
Anything else
- Is there anything else that would make therapy easier for you? You don’t need to give a reason.
- Would you like us to review these arrangements after a few sessions?
Forms and paperwork
Practice- Offer forms in more than one format: an accessible Word document, a tagged PDF, plain text, large print, and Easy Read where relevant.
- Let people complete forms by phone, by email, in the first session, or with help from someone they choose.
- Ask only what you need, and say why you are asking each question.
- Make disability and health questions optional, and explain how the answers will be used.
- Don’t set short deadlines for returning paperwork.
- Check that online forms work with screen readers and keyboard-only use, and don’t time out.
Consent
Practice- Accessible information: explain confidentiality, records, fees and cancellations in the client’s preferred format, and give time to decide.
- Check understanding respectfully: invite questions rather than testing recall.
- Ongoing, not one-off: revisit consent when methods change, for example body-focused work, recording, or sharing information.
- The client’s consent: a supporter can attend if the client wants, but speak to the client, and the decision is theirs.
- Presume capacity: disability, communication difference or an unusual decision is never, on its own, evidence that someone lacks capacity. Take all practicable steps to support someone to make their own decision.
- Withdrawing consent: make it easy to stop, change or pause. See Withdrawing Consent.
Records and sharing
Tell clients what you record, who can see it, and when you would share it. Offer to agree letters before they are sent. For many disabled clients, records have followed them around for years. See Medical Mistrust.
The first session
- Send practical information in advance: the route, the entrance, the room, where to wait, what will happen.
- Agree an access plan together, and write it down if the client wants.
- Set a date to review it. Access needs can change.
Evidence & sources
Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.
In England and Wales, the Mental Capacity Act 2005 begins with the principles that a person must be assumed to have capacity unless it is established that they lack it, that all practicable steps must be taken to help them decide, and that an unwise decision does not by itself show a lack of capacity. Mental Capacity Act 2005, section 1. Northern Ireland and Ireland have their own capacity legislation; check what applies where you practise.
Article 12 of the UN Convention on the Rights of Persons with Disabilities (“Equal recognition before the law”) requires states to provide access to the support disabled people may need in exercising legal capacity. UN CRPD Article 12
In Great Britain, the Equality and Human Rights Commission’s code of practice describes the duty on service providers to make reasonable adjustments as anticipatory: providers should think in advance about barriers disabled people may face. EHRC code, chapter 7
The checklists and intake questions are this site’s synthesis for practice. They are not legal advice and not a validated tool.
We have not located research on how accessible intake and consent processes affect disabled people’s access to, or experience of, psychotherapy.