Online Intake Form Utilization (Patient View)

Online Intake Forms Patient View

Clinic is responsible for providing Intake Forms to Patient via: Paper form in Clinic, Website: Link to Google Doc or Link to online PDF form, Email Campaigns, etc.

(We do not supply the actual forms)

When a New or Existing Patient is directed to send the clinic their files, they will access the link or button you have supplied.

When the screen loads, they will first have to indicate if they are an "Existing or New" Patient

For Existing Patients

To get started, they will make sure Existing is selected, fill out all necessary information (as it aids in the software locating the correct patient file), enter in a note of what they are supplying, and hit the "Submit Name and Add Files" button at the bottom to move on to the next page

The info they entered will appear under Contact information along with a box at the bottom where they can drag and drop a file or click on the box to locate the saved file on the pc.

When the file has been selected and attached, you will see a message underneath the upload box that states the upload has been done along with the file name of what was sent.

If the Patient needs to submit more than one file, they will click the box to upload again and each time a new file is uploaded it will add it to the list at the bottom. When they are finished, they will simply close the browser tab as indicated in the Red message at the bottom.

           

For New Patients

They will make sure New is selected and fill out all necessary information.

First/Last Name, Address, Email, Home/Work/Cell phone, Spouse information, and any notes they need to supply to the clinic.

All information entered here will transfer to the new file you will be creating for the new patient to cut down the amount of manual entry in getting them going.

Once finished, they will hit the "Submit Name and Add Files" button at the bottom to move on to the next page

The info they entered will also appear under Contact information along with a box at the bottom where they can drag and drop a file or click on the box to locate the saved file on the pc.

Just like with Existing Patients, when the file has been selected and attached, you will see a message underneath the upload box that states the upload has been done along with the file name of what was sent.

If the Patient needs to submit more than one file, they will click the box to upload again and each time a new file is uploaded it will add it to the list at the bottom. When they are finished, they will simply close the browser tab as indicated in the Red message at the bottom.