HIPAA readyWe sign a BAA before any patient data

Intake forms for health practices

Patients fill and sign on their phone or a front-desk tablet. Every signed form is kept as a PDF with its audit trail, ready to download.

Coming soon See the product

Northside Family Clinic / Today

WH Wendy Harlan New patient packet · 4 forms Signed 2m
DO Daniel Okeke PHQ-9 and GAD-7 Signed 9m
RE Ruth Ellison Dental registration Opened 14m
SW Sam Whitaker Telehealth consent Needs you 21m
LB Lena Brooks Financial policy Sent 33m
AP Aaron Patel Records release Sent 48m
GL Grace Lin Health history Signed 1h

Telehealth consent · version 3 · Sam Whitaker

Consent to telehealth visits

I agree to receive care by secure video with Northside Family Clinic. I can ask for an in-person visit at any time.

My visit may be recorded only if I agree in writing at the start of the call.

Signature and date of the patient or legal representative.

Build the form once. Every patient gets the same version.

Start from a blank page, a template or the PDF you use today. Add conditional questions, scored scales and signature fields, then publish. A published version never changes, and every submission keeps the version it was signed on.

Turns paper forms into fields

Upload the PDF or Word file you hand patients today. Intake Pro scans and converts it, and you place the fields.

6 forms ready to publish

New patient packet.pdf PDF
Financial policy.docx Word
HIPAA notice.pdf PDF
Telehealth consent.docx Word
Dental history.pdf PDF
Records release.pdf PDF

Starts from a governed template library

Screening scales, consents and registration forms with their sources and scoring kept with each template.

depression Ctrl K

Templates

PHQ-9, patient depression scaleScored
Beck Depression Inventory-IIScored
CES-DC, depression scale for childrenScored

↑↓ to moveEnter to add

Patients fill forms on their phone or in your waiting room

Text or email a private link, pair a tablet as a kiosk, or embed a form on your own site. A kiosk clears itself 60 seconds after each patient submits.

Reminders by text and email until the packet is signed
Forms keep working offline and send when the tablet reconnects
Forms in Spanish and 17 other languages, published only when the translation is complete

How this packet goes out

4 of 5 on

Text the linkTwo days before the visit
Email the linkFrom your practice's own domain
Allow kiosk check-inFront desk tablet, room 1
Require every signaturePacket stays open until all are signed
Offer SpanishReviewed translation, version 2

Every form signed and filed

Intake Pro keeps the signed version, its PDF and the audit trail together in one record. A change to the form makes a new version, so nothing a patient signed ever moves.

Every signed form, ready to download

Download one patient's signed packet as a PDF, a batch as a ZIP of PDFs, or every response to a form as a spreadsheet. Add the PDF to your chart or records system the way you do today.

Downloads in the format you file

A single PDF, a packet PDF, a ZIP of PDFs or a spreadsheet with one row per response.

4 downloads ready

Sam Whitaker packet.pdf Packet PDF
Signed this week.zip ZIP of PDFs
PHQ-9 responses.csv Spreadsheet
Telehealth consent.pdf PDF

Keeps the record behind each signature

Each submission keeps the version it was signed on, who signed it and when.

LOGTelehealth consent Signed

09:12  Link texted to patient
09:31  Opened on phone
09:38  Signed, version 3
09:40  Reminder texted
09:46  PDF kept with record
10:02  Downloaded by staff

Signed against version 3, which never changes.

Plans by seats and forms

Plans open soon. We quote prices per practice.

Starter

One location getting off paper

3 staff seats
1,000 forms a month
1 location

Professional

Growing practices with more than one front desk

10 staff seats
10,000 forms a month
Up to 10 locations

Enterprise

Groups, networks and multi-site organizations

50 staff seats
100,000 forms a month
Up to 100 locations

Questions

What practices ask before they move intake off paper.

SWSam Whitaker signednowTelehealth consent, version 3Open
PDF ready2mDaniel Okeke, PHQ-9 and GAD-7
RERuth Ellison opened14mDental registration, 2 of 5 pages

Is Intake Pro HIPAA compliant?

Intake Pro is built for protected health information: staff sign in with MFA, every read is scoped to your practice and logged, and files are encrypted. We sign a business associate agreement before you collect real patient data.

Can I bring the paper forms we already use?

Yes. Upload a PDF or Word file. Intake Pro scans it for viruses, converts it, and you place the fields on the page before you publish.

What happens to a signed form?

The signed version is kept as it was, with its signatures and a PDF. A change to the form makes a new version, so old submissions never move.

Does Intake Pro connect to our EHR?

Not yet. Today you download each signed form as a PDF, or a spreadsheet of responses, and add it to the chart yourself. EHR connections come later.