New Patient Intake Form

Protect sensitive patient data with a range of HIPAA-friendly features, including encryption, audit logging, and user-level permissions. When you use Formstack’s HIPAA plan, your practice can easily collect, store, and distribute electronic protected health information (ePHI) and keep it secure from external threats.

Looking to speed up your patient onboarding process? With our new patient intake form, automatically route patient data to the right staff members upon submission. Create custom emails to welcome new patients and explain next steps. You can even combine this form with other solutions to quickly generate patient documents and collect signatures to send to your EHR.

Enhance the patient experience with a mobile-friendly form that can be easily completed on any device. Once customized, you can add this patient intake form template to your website in a few quick steps—no tech experience necessary. Need to add more questions? If your intake form gets long, give patients the option to save and resume so they can complete it in more than one sitting.

Different patients have different histories. And the faster you can compile the right records, the sooner treatment can start. That’s why this patient intake form comes with Conditional Logic—so you can customize questions to each individual. Patients will only see the questions that are relevant to them based on previous answers, making it easy to fill out the form fast.