dl-intake-01

New Patient Intake Form

The new Patient Intake form version 01 is a detailed Complete Patient intake form that patients can fill out on their cell phones, laptop of PC, or just as easily in the clinic on an iPad or tablet. This form has 4 steps and includes Patient Information and Insurance; Medical & Dental History; Denture History; and Consent.

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dl-intake-03

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dl-intake-02

New Patient Intake Form

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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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