New Patient Intake Form
New Patient Intake form version 03 is a simple two-step intake form for new dental patients. Users can fill out this form online from their own smart phone; a home computer; or in the clinic on a clinic tablet. The form requests patient information and also acts as a basic healthcare questionnaire. It includes OHIHP (The Ontario Health Insurance Plan) numbers and RAMQ (Régie de l’assurance maladie du Québec – administers the Québec Health Insurance Plan. Although this field is centric to Ontario and Quebec Canada the this form and other forms can be customized at request for other areas.
It’s simple and quick to use.
Don’t waste money on expensive and complex upgrades to your practice management software.
Clinic Forms integrates with ANY existing system and requires no technical expertise to use.
Our team of customer support specialists will walk you through the entire process.
CANCEL AT ANY TIME – NO CREDIT CARD REQUIRED