dl-intake-02

New Patient Intake Form

The New Patient Intake form version 2 is a detailed Complete Patient intake form that patients can fill out online or on their cell phones. This form has 5 steps and includes Patient Information; Insurance information; Medical History; Dental History; & Consent.

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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

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