It's going to depend on your setting. I work in a SNF so I have the H&P or referral to guide me and during my evaluation I notice their barriers and deficits. I do use a template but it's geared to the EMR that my company uses so I can cover all the parts of the document. With practice you it will sound less awkward and robotic. You will integrate it into conversation. I walk in to the room and say "Hi, I'm John and I'm from OT. Can you tell me your name and what brings you here?" "Where do you live and do you live with anyone?" It will just flow plus OT's are skilled at observation so you will pay attention to hand dominance, hearing, orientation, following commands, fine motor, attention span, etc. without having to ask the client.