Trans-inclusive Reproductive Health Intake Form
The goal: Design a health intake form that is inclusive to transgender clients, for a holistic health practitioner's office that focuses on reproductive care.

In Spring of 2017, inclusion of transgender people was very much at the front of my mind. The Supreme Court had just decided not to weigh in on transphobic bathroom laws, and murders of trans women of color seemed to be spiking. I had been doing design work for my mother's holistic health care practice for several years, and suddenly came to the realization there was a lot we could do for her practice to make it more inclusive. Her health intake form seemed a good place to start!
Topic research:
I began with a simple web search into what it's like getting health services as a transgender person, and quickly came across a great set of guidelines published free online by Planned Parenthood. I also consulted with a pro - a psychotherapist who, in their own words "frequently consult[s] with and train[s] practitioners who are working to increase their level of cultural humility towards trans* and gender non-conforming clientele."
Stakeholder Interviews:
Next up, I interviewed the people who would be reading, and referencing the intake forms: the Founder and Lead Therapist of Wildflowers Wellness, Michelle Brown (also known as my mom!) and her Associate Therapist Anthony Zachmann. The office cat didn't get an interview but he knows he's important too.
Takeaways:
- Some parts of the intake form are frequently left unfilled, but serve as useful prompts in cases where they do apply.
- First visits with new clients usually center around the intake form, which is used as a way to guide the initial consultation and make sure important topics are covered. It needs to be easy for the practitioner to skim through and reference.
- Since the focus is usually on reproductive health, there are many topics that clients may start out feeling awkward talking about, but they usually warm up once the conversation starts.
- The intake form also serves as a way for clients to check in with themselves before the initial visit, and can help set the tone for the experience. The practitioner is considered a partner in the client's health, so it is good to encourage the client to take an active role.
The new intake form:
- Increases transgender inclusivity by combining the different "Male" and "Female" forms into one, prompting the client to fill in "all that applies to them."
- Adjusts wording to be more inclusive of different gender identities and family backgrounds.
- Is branded with Wildflowers style and professional, calm and light colors, with sections seperated out with color blocks for easy skimming.
- Adds a cover page that encourages the client to "re-center and check in with yourself" and "Thank yourself for making the time to take care of you."

Next up: A web version of the form?
This is meant to be a living document that changes over time as we get feedback, as well as a resource for other health practitioners who want inspiration for their own forms! 

Check out the full intake form here.  
Trans-inclusive Reproductive Health Intake Form
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Trans-inclusive Reproductive Health Intake Form

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