New Patient Intake Form

Register new patients fast with this HIPAA-friendly online form designed to make the intake process easier for everyone.

Simplify your workflows

Use this ready-to-go intake form to quickly register new patients and automatically send details to the appropriate caretakers and staff members. Whether you keep the pre-built questions for addiction treatment or customize them for different patient needs, you can create a seamless digital intake process within minutes. And because Formstack comes packed with features specifically for healthcare providers, you can rest assured the data you collect will stay secure with our HIPAA plan.

Keep data protected

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.

Simplify your workflows

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.

Improve the experience

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.

Customize questions

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.

Formstack's intuitive interface helps us build and modify a variety of medical forms to collect new patient data and route patient communication forms to medical assistants, the front office, billing, and administration.
Dr. Chris Bojrab
President of Indiana Health Group

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