One intake per service
Make a "New patient" link and a "Sports injury assessment" link. Each has its own questions, its own documents and its own public link on your subdomain, with your logo and colours.
For clinics & private practices
New patient intake forms, filled in before the appointment instead of on a clipboard in reception.
A new patient arrives ten minutes early to fill in four pages from memory, without their medication list or the referral letter. Intaky sends them one intake link before the visit, reminds them until it is done, and puts the history, documents and consent in front of the clinician in one place.
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What does a clinic need from a new patient?
Before a first appointment, most clinics and private practices need the patient’s details, their medical history and their consent, plus a few documents where they apply:
- Proof of identity, with date of birth and contact details.
- Existing conditions, current medication and dose, allergies, previous surgeries or hospitalisations, and smoking status.
- A referral letter, if another clinician referred them.
- Recent lab results or imaging reports, if they have them.
- Insurance provider, policy number and a copy of the insurance card, if they have cover.
- An emergency contact, and consent to the practice processing their health information to provide care.
Intaky’s patient intake template asks for exactly these, each document next to the questions it supports. For the wider process, see the intake process checklist.
Why new patient paperwork eats into appointment time
- A patient writes "blood pressure tablets" under medication and cannot remember the name or the dose.
- The referral letter is on their phone, so reception photocopies a screen, or asks them to email it to a shared inbox.
- An insurance card arrives with the front only, and the policy number is on the back.
- Someone at the front desk types a handwritten form into the practice system, and guesses at the allergies line.
The consultation is the care. The paperwork before it is a gathering job — and Intaky is built to do the gathering before the patient arrives.
The new patient intake template
A starter pack for individual patients of clinics and private practices. Each document sits next to the questions it evidences, patients are not asked again for the name and email they gave when they signed up, and the form ends with their consent and declaration. Everything below can be renamed, removed or added to in the form builder, so a physiotherapy intake and a dermatology intake can be two different links.
Patient — questions
- Personal detailsDate of birth and phone; sex and home address optional. Document: proof of identity
- Medical historyExisting conditions, current medication with dose and frequency, allergies, previous surgeries or hospitalisations, smoking, all optional. Documents: referral letter, previous test results
- InsuranceInsurance provider and policy or member number, left blank when paying privately. Document: insurance card
- Emergency contactContact name and phone, and their relationship to the patient
- Consent & declarationsConsent to the practice processing health information to provide care; information is accurate to the best of the patient’s knowledge
Patient — documents
- ✓ Proof of identity Required
- ✓ Referral letter If referred
- ✓ Previous test results Optional · several files
- ✓ Insurance card, front and back If insured · several files
Accepts PDF, Word, Excel and photos up to 10 MB each. Data is encrypted in transit and files are stored privately; your practice decides which questions and documents to ask for.
How it runs for a practice
Due before the first visit
Give the link a default due date and a reminder interval, and move any patient’s due date to the day before their appointment. Intaky emails the patient every few days until the form is done, only during working hours in your timezone, and stops after six reminders.
Check it, then file it
Accept the history, send back a one-sided insurance card with a note. Accepted items stay locked, and each decision is recorded on the case’s audit trail. Export the completed intake as a PDF with its documents, or let a webhook pass it to your own system on approval.
Questions about new patient intake
How do I get new patients to fill in their forms before the appointment?
Send each new patient one intake link with a due date before their first visit. Intaky emails them every few days until the form is done, only during working hours in your timezone, and stops after six reminders, so the clinician has the history in hand before the patient walks in.
What should a new patient intake form include?
Date of birth and contact details, existing conditions, current medication with dose, allergies, previous surgeries or hospitalisations, smoking status, insurance details if any, an emergency contact, consent to the practice processing health information for their care, and an accuracy declaration. Intaky's patient intake template starts with all of these, and you can rename, remove or add to any of them.
Can patients upload a referral letter and previous test results?
Yes. The medical history section has an optional referral letter and an optional previous test results item that accepts several files, so lab results and imaging reports can all go in one place. PDF, Word, Excel and photos are accepted, up to 10 MB each.
How do I collect insurance details from private and insured patients on the same form?
The insurance section is optional: insured patients give the provider and policy or member number and upload the front and back of their card, and patients paying privately leave it blank.
What happens when a patient uploads the wrong file?
You send back that one item with a note, for example an insurance card with only one side. The patient replaces only that item; everything you have already accepted stays locked.
Does the intake form carry our practice's branding?
Yes. Your logo and colours appear on your own subdomain, on every page the patient sees.
Is Intaky a medical records system, and is it HIPAA certified?
No to both. Intaky is an intake form and document collection tool, not an electronic health record, and it holds no HIPAA or other certification. Data is encrypted in transit and files are stored privately; your practice decides what to collect, reviews it, and is responsible for how health information is handled. The PDF export or a webhook on approval can move a completed intake into your own records system.
Other industries: all industries · schools & colleges · volunteer organisations · recruiters & HR
Try it on next week’s new patients.
Build the intake once. If reception stops typing up clipboards, use it for every first visit.
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