Patient intake form
Patient intake in a few clicks 🩺
Streamline your patient onboarding with this ready-made, no-code intake form. Collect essential information securely, automate your workflow, and keep your care team in sync, all while staying 100% HIPAA-compliant.
Perfect for private practices, clinics, and telehealth providers looking to simplify intake and reduce manual admin.
Steps of the form process:
Step 1: Patient fills out the embedded or portal-based intake form.
📩 Admin team receives an automatic email notification.
Step 2: Form triggers conditional actions based on patient responses:
Step 3: The team gets notified and views submissions in a secure dashboard.
✅ Custom emails are sent to different roles: front desk, nursing staff, or specialists, depending on form input.
Step 4: The form updates the patient pipeline with real-time status:
📊 View stages like “Form Submitted,” “Reviewed,” “Ready for Appointment.”
🧩 Features included in the template
- 1 ready-to-use, HIPAA-compliant patient intake form
- Conditional logic to personalize flow and notifications
- Email automation with customizable templates for staff communication
- Real-time analytics and insights into patient trends
- Patient pipeline to track progress and reduce no-shows
What you can do with the template
📨 1. Customize email alerts
Edit the emails to include links to appointment calendars, specialist contact info, or follow-up steps. You can also configure SMTP to send branded messages from your clinic's email.
✨ 2. Add conditional logic for smart routing
Trigger actions based on insurance type, age group, or reported symptoms. Keep your workflow efficient and patients informed.
🖌️ 3. Embed or create a patient portal
Easily embed the form on your website or turn the dashboard into a patient portal, complete with login, branding, and access controls.
🎨 4. Make it your own
White-label everything from forms to dashboards:
- Add your logo, brand colors, and custom fonts
- Use custom domains
- Remove Formaloo branding
- Even fully self-host on your servers if needed
🔐 5. Stay compliant
This template is built with HIPAA compliance in mind. All data is encrypted, securely stored, and access-controlled.
🚀 Start using the template today!
Click Use template to get started in seconds. Create a seamless onboarding experience for your patients, no code required.