Can this form be signed electronically?

Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided the signature shows intent, consent, attribution, and retention capability.

When is notarization required?

Notarization is state-specific and typically required for deeds, some POAs, and certain acknowledgements. Check the receiving party’s requirements and state rules before requiring notarization.

What if the signer uses a different name on ID?

Document the discrepancy, obtain supporting evidence (name change certificate), and consider requiring an affidavit or additional ID to confirm identity and authority.

Do I need a BAA to use e-signature for patient forms?

Yes. If the intake form contains protected health information, execute a HIPAA Business Associate Agreement with the e-sign provider before using their services.

How do I correct a signed intake form?

Avoid editing a signed record. Create an amendment or corrected form, have parties sign the amendment, and retain both the original and corrected documents for auditability.

How long must I keep signed intake forms?

Retention varies: IRS rules start at 3 years (IRC §6501(a)); HIPAA requires 6 years (45 CFR §164.530(j)). Extend retention for state-specific or industry-specific mandates.

Electronic Signature
Templates
Miscellaneous
Client Intake Relationship Form

Client Intake Relationship Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

CLIENT INTAKE RELATIONSHIP FORM

Effective Date:

WHEREAS

WHEREAS Client Name: seeks to engage professional services from Service Provider Name: for the purposes described in this Agreement; and

WHEREAS Service Provider represents that it possesses the requisite skills, experience and resources to perform the services set forth herein and is willing to provide such services pursuant to the terms and conditions of this Agreement.

CLIENT INFORMATION

Primary Contact Name Client Business / Organization Name Client Address

Email

Phone

Entity Type (select all that apply)

Individual / Sole Proprietor LLC Corporation Partnership Other:

ENGAGEMENT DETAILS

Services Requested (check all that apply):

Consulting / Advisory Services Project-based Work Retainer / Ongoing Support Other:

Scope of Work

PAYMENT TERMS

The client agrees to compensate the Service Provider as follows. All amounts are stated in U.S. dollars.

Total Fee / Project Amount Payment Schedule Late Payment Fee

Invoices are due within the timeframe stated in the payment schedule. Unpaid amounts shall accrue interest at the rate set forth above until paid. Client is responsible for all reasonable costs of collection, including attorneys' fees, incurred by Service Provider in enforcing payment obligations.

TERM AND TERMINATION

This Agreement commences on Start Date: and, unless earlier terminated in accordance with this section, continues until End Date: . Either party may terminate this Agreement without cause by providing written notice to the other party no fewer than days prior to the intended termination date.

Either party may terminate immediately for material breach of this Agreement that is not cured within fifteen (15) days after receipt of written notice specifying the breach. Termination does not relieve Client of the obligation to pay for services performed and expenses incurred through the effective date of termination.

CONFIDENTIALITY

For purposes of this Agreement, "Confidential Information" means non-public information disclosed by one party to the other that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure. Each party shall hold Confidential Information in strict confidence, shall not disclose it to third parties except as expressly permitted, and shall use it solely for performance of this Agreement.

Confidentiality obligations are mutual Confidentiality obligations apply only to Service Provider

Confidentiality obligations shall not apply to information that is (a) publicly known through no fault of the receiving party, (b) rightfully received from a third party without restriction, (c) independently developed without use of the other party's Confidential Information, or (d) required to be disclosed by applicable law, in which case the receiving party shall provide prompt notice to the disclosing party and cooperate in any lawful effort to limit disclosure.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict-of-law principles. The parties submit to the exclusive jurisdiction of the state and federal courts located in that State for resolution of disputes arising under this Agreement.

ENTIRE AGREEMENT

This Agreement, together with any exhibits and written statements of work executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, negotiations, and communications, whether oral or written. No modification of this Agreement shall be effective unless in a writing signed by both parties.

ADDITIONAL REPRESENTATIONS AND AUTHORIZATIONS

Client represents and warrants that it has full authority to enter into this Agreement and that the individuals executing this Agreement on behalf of Client are authorized to bind Client. Client authorizes Service Provider to perform the requested services and to charge the payment method provided for amounts due under this Agreement.

Billing Contact (if different) Notes / Special Instructions

Client:

By:

Date:

Service Provider:

By:

Date:

What the Client Intake Relationship Form Is and when it’s used

The Client Intake Relationship Form collects essential information about a new or existing client relationship, documenting identities, contact details, scope of services, billing arrangements, and consent for data processing. It serves as the official record that initiates engagement, clarifies roles, and supports compliance checks such as identity verification, conflict screening, and any industry-specific authorizations required before services begin.

Why a clear intake form matters for risk and service delivery

A well-structured Client Intake Relationship Form reduces onboarding time, supports regulatory compliance (ESIGN, UETA), and provides a defensible record of client consent and expectations. Accurate intake helps avoid billing disputes, confidentiality lapses, and delays caused by missing or inconsistent information.

Who completes and relies on the intake form

The form is completed by onboarding staff, account managers, or the client directly depending on your workflow and verification requirements.

Small businesses and freelancers use intake forms to capture client contact, scope, and payment terms before starting work.
Legal and professional services collect conflict-of-interest details, identification, and signed engagement terms for compliance.
Healthcare and financial organizations require additional consent language and identity verification elements during intake.

Store a signed copy in the client file and attach supporting documents (IDs, corporate resolutions) when required for later audits or dispute resolution.

Step-by-step: complete a Client Intake Relationship Form

Follow this sequence to gather accurate client information, confirm authority to sign, and secure consent for electronic records and signatures.

01

Prepare the form: Use a current template that lists required fields and supporting documents.
02

Collect identity data: Obtain full legal names, DOB or business EIN, and a government ID when required.
03

Confirm authority: Verify signer authority for entities and record job title or corporate role.
04

Execute and retain: Obtain signatures (electronic or wet) and store the signed file in the client record.

Digital workflow settings to use when sending intake forms

Configure these settings to reduce friction and preserve a complete audit trail when you distribute the intake form electronically.

Field	Configuration
Sender Account	Use an organization-level account with templates and centralized folder access.
Signer Authentication	Enable email plus optional SMS or KBA for higher-assurance signings.
Template Enforcement	Lock required fields and use conditional logic to show only relevant sections.
Notifications	Enable reminders and send completed copies automatically to relevant stakeholders.

How electronic completion typically flows

This simplified workflow shows the common sequence when a Client Intake Relationship Form is completed online and signed electronically.

Upload: Owner uploads the intake template and applies required fields.
Send: System emails signer a secure link or generates a signing link.
Authenticate: Signer confirms identity via email, SMS code, or KBA.
Sign & Store: Signatures captured, audit trail recorded, and file archived in the client folder.

Essential sections to include in a professional intake form

A complete Client Intake Relationship Form groups client identity, relationship details, permissions, payment terms, compliance checks, and signature blocks for clarity and enforceability.

Client Identity

Full legal name, address, tax ID or SSN as applicable, and primary contact details to establish identity and tax reporting obligations.

Relationship Details

Describe services, expected deliverables, start date, and any exclusivity or non-solicit terms to set mutual expectations.

Authority and Role

Capture signer title, corporate authority or POA details and request supporting documentation for third-party signers where needed.

Payment Terms

State fees, billing schedule, accepted payment methods, and any late fee terms to reduce future disputes and enable accurate bookkeeping.

Privacy & Consents

Record consent for electronic communications, data sharing, and any HIPAA/FERPA-related authorizations when handling protected information.

Signatures & Dates

Include signature, printed name, title, and date fields for each party; specify whether initials are required on each page.

Security and compliance details to record with signed forms

Encryption: AES-256 at rest; TLS 1.2/1.3 in transit

Authentication: Email, SMS, KBA, or advanced signer methods

Audit Trail: Timestamps, IP, and action history retained

BAA Availability: HIPAA BAA available when required

Regulatory Standards: Compliant with ESIGN, UETA, 21 CFR Part 11

Certifications: SOC 2 Type II, ISO 27001, PCI DSS

Key risks and consequences of inaccurate intake records

Incorrect Signatory: May void agreement or require re-execution

Missing Consent: Regulatory exposure for consumer-facing transactions

Data Breach: Possible HIPAA/CCPA penalties and corrective actions

Tax Reporting Errors: Backup withholding or IRS notices

Delayed Services: Operational delays while verification is completed

Retention Failures: Inadmissible records in disputes or audits

Common mistakes to avoid when preparing intake forms

Requesting incomplete identification or accepting informal proof increases fraud risk and slows onboarding.
Using inconsistent name formats across documents causes mismatches in tax reporting and bank account validation.
Failing to capture explicit electronic-consent language can render e-signed records noncompliant for consumer transactions under ESIGN.
Not storing a tamper-evident signed copy and audit trail may weaken enforceability during disputes or regulatory review.

Timing and practical deadlines to manage intake completion

Set internal deadlines that align with client start dates, billing cycles, and regulatory notice periods to avoid service or compliance gaps.

Provide Before Work Starts:

Complete intake and verification prior to commencing billable services.

Respond to Requests:

Supply requested tax or ID documents within 10 business days when asked.

Record Retention Start:

Retention begins on the effective date or signature date.

Update on Changes:

Amend contact or authority details within 30 days of notice.

Internal Review:

Conduct compliance reviews annually or when laws change.

Pricing snapshot: signNow compared with common e-sign vendors

This vendor comparison highlights starting prices, trial availability, bulk-send capability, HIPAA support, and envelope limits to inform platform selection for intake forms.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently asked questions about Client Intake Relationship Forms

Answers to common practical and compliance questions when preparing, signing, and storing intake forms.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided the signature shows intent, consent, attribution, and retention capability.
When is notarization required?
Notarization is state-specific and typically required for deeds, some POAs, and certain acknowledgements. Check the receiving party’s requirements and state rules before requiring notarization.
What if the signer uses a different name on ID?
Document the discrepancy, obtain supporting evidence (name change certificate), and consider requiring an affidavit or additional ID to confirm identity and authority.
Do I need a BAA to use e-signature for patient forms?
Yes. If the intake form contains protected health information, execute a HIPAA Business Associate Agreement with the e-sign provider before using their services.
How do I correct a signed intake form?
Avoid editing a signed record. Create an amendment or corrected form, have parties sign the amendment, and retain both the original and corrected documents for auditability.
How long must I keep signed intake forms?
Retention varies: IRS rules start at 3 years (IRC §6501(a)); HIPAA requires 6 years (45 CFR §164.530(j)). Extend retention for state-specific or industry-specific mandates.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now