Falconet

New patient intake forms for physical therapy and chiropractic practices

A new-patient form your patients fill in before the first visit, so the first appointment starts with their history already in hand.

What's wrong with the packet you use now?

A new patient comes in fifteen minutes early to fill in the packet: history, medications, where it hurts and since when, the consent, a copy of the insurance card.

"See attached" where the medications should be. A question about previous surgery left blank. A signature, and a date that could be a 7 or a 1.

So the front desk reads it back, asks what was skipped, and enters the rest into your practice software, while the first appointment of the day waits.

What does a better intake form do?

It gets the history before the visit, from the patient, at home, with time to look up what they're taking.

• It asks why they're coming in first, then only what that needs. A patient coming in after surgery gets asked for the procedure and the date. A patient with a stiff neck never sees those questions.
• It won't send without a date of birth, a phone number, and an answer to the medications question, even if that answer is "none."
• The patient can attach a photo of their insurance card, front and back.
• The patient signs the consent on the form, and the signed copy stays on record.
• A form filled in at home reaches you before the appointment, not in the waiting room.

Someone still enters the answers into your practice software. They enter them from typed text, with nothing left to decipher.

Isn't the form on my website enough?

The contact box on your website asks every patient the same few questions: name, email, message. Changing it often means going back to whoever built your site, and paying for their time. So it stays the way it was built.

A live form is yours to change. Add a question when you add a service, the same day and without calling anyone.

Isn't a fillable PDF the same thing?

This isn't a fillable PDF. A PDF packet on your website asks the patient to download it, fill it in, save it and email it back. And it walks every patient through every question, whatever brought them in. A form on the page asks only what each patient's visit needs, and it's in your inbox the moment they send it.

What about patients who walk in without filling it in?

Put the form on a tablet at the front desk, or print it as a QR code in the waiting room, and they fill it in on the spot. The tablet can reset after each patient, so the next one starts on a blank form.

What does the patient see after they send it?

A confirmation you write, on screen the moment they send, which can tell them what to wear and when to arrive. A copy of what they told you can also go to their email, sent by the form, not by you.

Who is this not for?

If your practice software already sends intake forms that land in the patient chart, use them. And if you need the form to write straight into your practice software, that's a different conversation: tell me which system you run, and we'll look at what connecting it takes.

This is for the practice whose new-patient packet is still paper, a PDF, or an email thread. A large practice with many people building forms is a different conversation too.

What does it cost?

The platform we deploy on has a free entry tier, and the form we build runs on it. The free tier shows the platform's own branding on the form and has some monthly limits. A practice that outgrows the free tier can move to a paid one, on terms the platform sets, not us.

Quinn