10.2 Patient Intake Forms

Patient Online Intakes allows you to send your intake forms to your patients via email prior to their appointment. This expedites your patient check-in by allowing them to fill out the initial intake forms on their own device at home prior to them arriving at the office.

Sending Intake Forms

• Once you have added the patient & their email address into the system, you can send the forms in 2 ways:

  • From the Patient Profile: On the Clinical Dashboard (under the basic box) click ‘Send Patient Intakes’

  • From the Schedule: Click the appointment vCard and click ‘Send Patient Intakes’.

Intakes Icon (located on the navigation bar on the main interface)

Open

• The intakes icon will display the number of new forms you have received that have not been viewed.

• This tab will show you information on who has received their intakes, who has completed their intakes, and how much of the intakes the patient has completed. 

Intake Forms Received

Open

• The ‘INTAKE FORMS RECEIVED’ section will display anyone who has clicked on the link to open up their intakes and how far through the intakes they have gone.

• Filter by: You can filter by Active or Archived intake forms.

• Options: Click the folder icon to open the forms and the white zipper icon to archive.

  • Archiving will simply move them out of the ‘Active’ list after you have verified their intake forms. They will always be present in the patient’s medical file.

Pending Intake Forms

• The patients listed in this section have not yet opened the link since you have sent it.

• Options: Click the paper airplane icon to resend the intakes and the trash can to delete.

Intake Administration Button

The Intake Administration button found at the bottom of the screen will open a new tab for you to view and customize your forms.

• Users can enter the Admin Portal to customize and view their intake forms.

• Upload your practice logo by clicking the ‘Browse for Logo' button. (Note: Must select either jpg/png/gif files)

Intake Administration

The intake administration tab allows you to upload your logo, view your live forms that are being sent to your patients, customize your intake forms, and access the patient self check-in. (Please see section 10.3 Patient Self Check In for instructions on how to utilize this feature)

Live

• Preview live form: Shows all published data for the most recent version of the intakes – This is what the patients will see when they complete the intake forms.

• Clear demo input: Clears out any data that may have been entered while in Preview mode – Clicking this button will not clear any previously saved data.

Design

• Click the Design button to enter the design area where you are able to customize editable sections of the intakes. 

• Clear demo input: Clears out any data that may have been entered while in Preview mode – Clicking this button will not clear any previously saved data.

Consent Documents

• Various consent documents are available for customization. Users may view, edit, delete, and add new forms. Users can also change the order of the documents by dragging/dropping.

  • The pencil icon allows the user to open the document for editing. When editing a document, a Microsoft Word style editor opens to allow for complete customization.

  • The trash can icon will delete the document.

  • The four point arrow allows the user to drag/drop the document within this page.

  • To add a document select 'Click to add document'.
    
    
    

     

Insurance

• This tab cannot be customized. The information from his tab will not populate into the patient's file but will show on the PDF of their intake forms so that you are able to verify their insurance information. You will then be able to input this manually.

Complaints, System Overview, Lifestyle, Medical History, and Family History  

• Once completed, all of the information populated within these tabs will pull through to the patient’s profile in ChiroFusion.

• The complaints tab will populate into the Exam or SOAP note under the subjective information.

• System Overview, Lifestyle, Medical History, and Family History will populate into the Medical Hx tab of the patient's profile.

'Other' Information

This tab allows users to create questionnaires that may be unique to their practice (i.e. PI Documents, Pediatric Forms, etc.) Within the patient’s profile, these forms will generate a preview within the Medical HX area under the Patient Intake tab.

• To create a form, you will need to click the 'pencil' icon. You will then click and drag the type of item you wish to appear on the form. You will then click the pencil to the right of the item to make your edits.  

  • Page Header: This is usually an item to name the entire page (i.e. Please answer any of the following questions that apple to your visit).

  • Section Header: This text will display in a smaller font for different sections of the page (i.e. Auto Accident)

  • Text Field: This is a space for you to ask a question and your patient can answer with a few words.

  • Text Area: This is a space for you to ask a question and your patient can answer with a few sentences.

  • Date: Use this to ask your patient to enter in a specific date.

  • Select: This option allows you to create a selection drop-down. You will ask a question and then give your patient’s options to choose from the drop down.

  • Checkbox: WIth this option you can list an item/question and your patient can select the checkbox if applicable.

  • Checkbox Group: This allows you to give your patients several checkbox options so that they can select multiple items when answering your question.

  • Radio Group: This allows you to ask a question and list multiple options where your patient can only select one when answering.

  • Paragraph: This allows you to input a paragraph for explanation.

  • Number: Allows you to ask a patient a question where they must enter a number (for example, a pain scale).

• Each above item will have several options to customize the questions. Below are explanations of those options:

  • Label: Edit the label to input what you want the header to say.

  • Type: This changes the size of the font. H1 = biggest, H3 = smallest.

  • Required: Select this checkbox if you want to ensure every person who fills out the intakes must fill out this field.

  • Help Text: This creates a ? icon for the patient to hover over to give them more instructions on how to answer the question.

  • Placeholder: This will display in the box itself to tell the patients what to type.

  • Value: This will overwrite the Placeholder and enter in the value into the box for the patient.

  • Max Length: This will allow you to set a limit of characters for the box.

  • Rows: Limits the number of rows in the text area

  • Allow Multiple Selections: When this is selected the patient can choose multiple items from the drop down menu.

  • Options: These will be the options in the drop down menu.

  • Toggle: Shows a toggle button instead of a check box.

  • Enable Other: This allows your patients to select ‘Other’ and enter in their own answer.

  • Content: This is what will display as text in your paragraph.

  • Min: This is the minimum numerical amount for the option.

  • Max: This is the maximum numerical amount for the option.

  • Step: This tells the system what to count by for the number option (1s, 5s, 10s,).

Once the user has completed customizing the Online Patient Intake Forms, return to the main Admin Page to publish the documents. The updates will not be live until the ‘Publish!' button is clicked. Once the forms are published, those changes will be sent to your patients moving forward. You can also click ‘Preview live forms’ to see how the forms look from your patient’s point of view.