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Create intake forms that accepts eSignature from patients

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Prefill Google Forms & send as email to customers

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Signature workflow for Google Forms

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Assign different points for each answer & calculate score

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Create intake forms using Google Forms

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Form builder for intake form
Intake form for patients

Built for healthcare companies

Add eSignature to Google Forms. Send signed PDF to EHR.

Patient Intake Form
Patient Intake Form

For General

Psychiatry intake form
Psychiatry intake form

For Psychiatry

Dental intake form
Dental intake form

For Dental

Optometry intake form
Optometry intake form

For Optometry

Chiropractic intake form
Chiropractic intake form

For Chiropractic

Pediatric intake form
Pediatric intake form

For Pediatric

Physiotherapy intake form
Physiotherapy intake form

For Physiotherapy

Podiatry intake form
Podiatry intake form

For Podiatry

Dermatology intake form
Dermatology intake form

For Dermatology

Medical intake form
Medical intake form

For Medical

Payment Pre-authorization Form
Payment Pre-authorization Form

For Pre-care

Patient Payment Form
Patient Payment Form

For Post-care

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Features

Patient intake forms

Choose from pre-built intake forms for psychiatry, dental, podiatry, dermatology, optometry, physiotherapy, pediatric and more Collect essential patient information such as personal details, demographic details, emergency contact, medical history, current symptoms, health goals & more Have your patients electronically sign the HIPAA compliant documents for consent and privacy when they complete the intake forms Setup your forms to easily collect online payments or get pre-authorization upfront from the patients and then collect payments post-care
Choose from pre-built intake forms for psychiatry, dental, podiatry, dermatology, optometry, physiotherapy, pediatric and more
Collect essential patient information such as personal details, demographic details, emergency contact, medical history, current symptoms, health goals & more
Have your patients electronically sign the HIPAA compliant documents for consent and privacy when they complete the intake forms
Setup your forms to easily collect online payments or get pre-authorization upfront from the patients and then collect payments post-care
Choose from pre-built intake forms for psychiatry, dental, podiatry, dermatology, optometry, physiotherapy, pediatric and more
Choose from pre-built intake forms for psychiatry, dental, podiatry, dermatology, optometry, physiotherapy, pediatric and more
Collect essential patient information such as personal details, demographic details, emergency contact, medical history, current symptoms, health goals & more
Collect essential patient information such as personal details, demographic details, emergency contact, medical history, current symptoms, health goals & more
Have your patients electronically sign the HIPAA compliant documents for consent and privacy when they complete the intake forms
Have your patients electronically sign the HIPAA compliant documents for consent and privacy when they complete the intake forms
Setup your forms to easily collect online payments or get pre-authorization upfront from the patients and then collect payments post-care
Setup your forms to easily collect online payments or get pre-authorization upfront from the patients and then collect payments post-care

Customize intake forms

Intuitive form builder allows healthcare providers to easily create intake forms from scratch or customize existing intake forms to collect essential patient information Choose from a wide range of question types, including multiple-choice, checkboxes, dropdown, file upload and open-ended questions to create your intake forms Mark fields as required, add response validations, calculate answers for fields such as age to ensure that the patient submissions are complete and accurate Customize the thank you page to include the next steps and relevant instructions for their appointment or redirect users to your webpage
Intuitive form builder allows healthcare providers to easily create intake forms from scratch or customize existing intake forms to collect essential patient information
Choose from a wide range of question types, including multiple-choice, checkboxes, dropdown, file upload and open-ended questions to create your intake forms
Mark fields as required, add response validations, calculate answers for fields such as age to ensure that the patient submissions are complete and accurate
Customize the thank you page to include the next steps and relevant instructions for their appointment or redirect users to your webpage
Intuitive form builder allows healthcare providers to easily create intake forms from scratch or customize existing intake forms to collect essential patient information
Intuitive form builder allows healthcare providers to easily create intake forms from scratch or customize existing intake forms to collect essential patient information
Choose from a wide range of question types, including multiple-choice, checkboxes, dropdown, file upload and open-ended questions to create your intake forms
Choose from a wide range of question types, including multiple-choice, checkboxes, dropdown, file upload and open-ended questions to create your intake forms
Mark fields as required, add response validations, calculate answers for fields such as age to ensure that the patient submissions are complete and accurate
Mark fields as required, add response validations, calculate answers for fields such as age to ensure that the patient submissions are complete and accurate
Customize the thank you page to include the next steps and relevant instructions for their appointment or redirect users to your webpage
Customize the thank you page to include the next steps and relevant instructions for their appointment or redirect users to your webpage

Patient engagement and experience

Prefill patient details including PHI across multiple forms and assessments, reducing the risk of errors and improving the patient experience Enable autosave and allow patients to save their progress and return to the form at a later time without losing any responses, allowing them to complete it at their own pace Send intake forms to patients via email and make it easy for them to complete it on any device, whether it's a desktop computer, laptop, tablet, or smartphone Schedule timely reminders to patients to ensure that they have enough time to complete the intake forms prior to their appointment
Prefill patient details including PHI across multiple forms and assessments, reducing the risk of errors and improving the patient experience
Enable autosave and allow patients to save their progress and return to the form at a later time without losing any responses, allowing them to complete it at their own pace
Send intake forms to patients via email and make it easy for them to complete it on any device, whether it's a desktop computer, laptop, tablet, or smartphone
Schedule timely reminders to patients to ensure that they have enough time to complete the intake forms prior to their appointment
Prefill patient details including PHI across multiple forms and assessments, reducing the risk of errors and improving the patient experience
Prefill patient details including PHI across multiple forms and assessments, reducing the risk of errors and improving the patient experience
Enable autosave and allow patients to save their progress and return to the form at a later time without losing any responses, allowing them to complete it at their own pace
Enable autosave and allow patients to save their progress and return to the form at a later time without losing any responses, allowing them to complete it at their own pace
Send intake forms to patients via email and make it easy for them to complete it on any device, whether it's a desktop computer, laptop, tablet, or smartphone
Send intake forms to patients via email and make it easy for them to complete it on any device, whether it's a desktop computer, laptop, tablet, or smartphone
Schedule timely reminders to patients to ensure that they have enough time to complete the intake forms prior to their appointment
Schedule timely reminders to patients to ensure that they have enough time to complete the intake forms prior to their appointment

Manage patient intakes

Easily keep track of patient intake form submissions using the Responses dashboard and improve form completion rates with timely reminders Download the patient intake form submission as a pdf document when required or automatically generate a pdf and sync it to your Google Drive Automatically sync form responses to Google Sheets or export patient intake data from Hipaache reports to Google Sheets for easy analysis Collect feedback about the patient experience, satisfaction with care, overall wellbeing and use this information to improve the patient onboarding
Easily keep track of patient intake form submissions using the Responses dashboard and improve form completion rates with timely reminders
Download the patient intake form submission as a pdf document when required or automatically generate a pdf and sync it to your Google Drive
Automatically sync form responses to Google Sheets or export patient intake data from Hipaache reports to Google Sheets for easy analysis
Collect feedback about the patient experience, satisfaction with care, overall wellbeing and use this information to improve the patient onboarding
Easily keep track of patient intake form submissions using the Responses dashboard and improve form completion rates with timely reminders
Easily keep track of patient intake form submissions using the Responses dashboard and improve form completion rates with timely reminders
Download the patient intake form submission as a pdf document when required or automatically generate a pdf and sync it to your Google Drive
Download the patient intake form submission as a pdf document when required or automatically generate a pdf and sync it to your Google Drive
Automatically sync form responses to Google Sheets or export patient intake data from Hipaache reports to Google Sheets for easy analysis
Automatically sync form responses to Google Sheets or export patient intake data from Hipaache reports to Google Sheets for easy analysis
Collect feedback about the patient experience, satisfaction with care, overall wellbeing and use this information to improve the patient onboarding
Collect feedback about the patient experience, satisfaction with care, overall wellbeing and use this information to improve the patient onboarding

HIPAA compliance

The data collected using forms is encrypted to ensure that patient information is protected during transmission and at rest Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI when exporting the data Automatically mask PHI when sending responses on email to ensure that patient data is only visible to authorized personnel and not inadvertently disclosed Share prefill links via email without exposing PHI, safeguarding sensitive patient data from the initial email to the completion of the forms
The data collected using forms is encrypted to ensure that patient information is protected during transmission and at rest
Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI when exporting the data
Automatically mask PHI when sending responses on email to ensure that patient data is only visible to authorized personnel and not inadvertently disclosed
Share prefill links via email without exposing PHI, safeguarding sensitive patient data from the initial email to the completion of the forms
The data collected using forms is encrypted to ensure that patient information is protected during transmission and at rest
The data collected using forms is encrypted to ensure that patient information is protected during transmission and at rest
Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI when exporting the data
Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI when exporting the data
Automatically mask PHI when sending responses on email to ensure that patient data is only visible to authorized personnel and not inadvertently disclosed
Automatically mask PHI when sending responses on email to ensure that patient data is only visible to authorized personnel and not inadvertently disclosed
Share prefill links via email without exposing PHI, safeguarding sensitive patient data from the initial email to the completion of the forms
Share prefill links via email without exposing PHI, safeguarding sensitive patient data from the initial email to the completion of the forms

Google workspace integration

Create customized intake forms using the Hipaache addon for Google Forms or use the pre-built templates with seamless Google Forms integration Sync Google Forms responses to Google Sheets or export data from Hipaache reports to Google Sheets for easy analysis of patient data Send automated reminders and notifications to patients using your Google Mail, prompting them to complete their forms and follow-up activities Automatically generate a pdf with complete patient data and e-signatures when they complete the intake form and sync the files to your Google Drive
Create customized intake forms using the Hipaache addon for Google Forms or use the pre-built templates with seamless Google Forms integration
Sync Google Forms responses to Google Sheets or export data from Hipaache reports to Google Sheets for easy analysis of patient data
Send automated reminders and notifications to patients using your Google Mail, prompting them to complete their forms and follow-up activities
Automatically generate a pdf with complete patient data and e-signatures when they complete the intake form and sync the files to your Google Drive
Create customized intake forms using the Hipaache addon for Google Forms or use the pre-built templates with seamless Google Forms integration
Create customized intake forms using the Hipaache addon for Google Forms or use the pre-built templates with seamless Google Forms integration
Sync Google Forms responses to Google Sheets or export data from Hipaache reports to Google Sheets for easy analysis of patient data
Sync Google Forms responses to Google Sheets or export data from Hipaache reports to Google Sheets for easy analysis of patient data
Send automated reminders and notifications to patients using your Google Mail, prompting them to complete their forms and follow-up activities
Send automated reminders and notifications to patients using your Google Mail, prompting them to complete their forms and follow-up activities
Automatically generate a pdf with complete patient data and e-signatures when they complete the intake form and sync the files to your Google Drive
Automatically generate a pdf with complete patient data and e-signatures when they complete the intake form and sync the files to your Google Drive

Customers love us

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user.

I am not tech savvy. I chose formesign to help create registration links for clients. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

We found in Formesign a perfect solution to collect a big amount of signatures for consent forms in a short amount of time. Our experience was great and the support team was really helpful.

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