Patient Intake Form

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The patient intake form allows you to request and record information about your patients before they arrive for their appointment. You can request personal details, payment details, funding and referral details, social history information and even attach clinical questionnaires to be completed. Once a patient submits the form, their information is automatically updated in Halaxy. This lets you get to know your patients before their appointment for better treatment outcomes.

You can create your own patient intake forms as well as customise the prebuilt one in Halaxy.

For privacy and security reasons, patient intake forms are emailed using a secure link contained within the email template. When patients click the link, they are emailed a secure code that they must enter in order to access the form. The link expires one week after being sent, so patients must complete the form within that time.

Enabling patient intake forms in settings

To use a patient intake form, you must first enable it in your settings by following the steps below:

  1. Click Settings > General.
  2. In the Patient Portal section, click the Edit (pencil) icon next to "Patient intake form" (NOTE: Make sure you are editing "Patient intake form" under Patient Portal, not Clinical Settings). mceclip0.png
  3. At the first radio button option, click Enable. mceclip1.png

  4. Click Submit.

Creating and editing a patient intake form

To create or edit a patient intake form:

  1. Click Settings > General.
  2. In the Clinical Settings section, click the Edit (pencil) icon next to "Patient intake form" (NOTE: Make sure you are editing "Patient intake form" under Clinical Settings, not Patient Portal). mceclip2.png
  3. Click Add Form to add a new patient intake form, or click the name of an existing form in the list to edit that form.
  4. In the Template Name field, give the intake form a name.In the Description field, enter a description ("e.g. "Brunswick Location Intake Form").
  5. In the Intake Template section, tick the options you want to include as part of the intake form.mceclip1.png
  6. If you are including funding information, tick the Include Funding Information checkbox. A new checkbox will appear called "Include Referrer Details" - tick to ask for referrer details from each funding body. Click the field below to select which funding bodies you would like to request funding information for. You can add multiple funding bodies.IntakeForm_Funding.png
  7. In the following field, click to add any clinical templates you wish to add to the intake form (e.g. pain charts or clinical questionnaires) (NOTE: You can only select templates that have been imported/added as templates in your practice group).
    IntakeForm_Templates.png
  8. Click Save.

Under "Section", you can optionally add questions that are sorted under section headings. The answers to these questions will appear as a clinical note in the patient's profile.

To add questions:

  1. In the "Section Heading" field, add a section heading.
  2. In the Description field, add a description for the section.
  3. Click "Add another question" to add a question.
  4. In the Question / Title field(s), start typing the name of your question, if you have already created the question it will appear in the list, if not click on add as a new template question to create a new question.
  5. Tick the "Mandatory" checkbox if you want to force patients to answer the question before submitting the form.
  6. Add as many sections and questions as desired. Use the Up and Down arrows on the right to change the question order.
  7. Click Save at the bottom of the form.
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Sending a patient intake form to patients

You can send a patient intake form to patients via two methods:

Set patient intake forms to be automatically sent when a patient completes an online booking

  1. Click Settings > General.
  2. In the Patient Portal section, click the Edit (pencil) icon next to "Patient intake form" (NOTE: Make sure you are editing "Patient intake form" under Patient Portal, not Clinical Settings).
  3. Under "Send patient online form for online booking", select Enable.
  4. In the Send Form drop-down menu, select whether you want to send the intake form with every online booking or only on the patient's first online booking with a practice group.
  5. In the Patient Form drop-down menu, select the intake form to send.
  6. In the Communication Template drop-down menu, select "Intake form template" (or any template you have created that includes the dynamic term [Online Form Link]). This is the email template the patient will receive, containing a secure link to the intake form.
  7. Click Submit.
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RESULT: Whenever a patient makes a booking that fits the rules you have set up, the form is emailed using a secure link within the email template that expires after one week. When patients click the link, they are further emailed a secure code they must enter in order to access the form. Patients must enter the code and complete the form before the link expires.

Manually send a patient intake form on demand

  1. Click a patient's name to go to a patient's General profile.
  2. In the Contact Details section, ensure that a patient has a valid email address (otherwise, click Edit in the section header with the patient's name to add one).
  3. Click the "Send an Intake Form" icon to the right of the patient's email address.Patient_Profile_Send_Intake_Form.png
  4. The Patient Intake Form pop-up appears. In the Intake Form drop-down menu, select the intake form you wish to use.
  5. Complete the Sender Email, Sender Name, Subject and other email fields, including CC and BCC email addresses to copy in.
  6. In the Template field, select "Intake form template" (or any template you have created that includes the dynamic term [Online Form Link]). The Email Content field below will automatically populate with the template you select.
  7. Make any changes you would like in the Email Content field, including formatting changes.
  8. Click Submit.
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RESULT: The form is immediately emailed using a secure link within the email template that expires after one week. When patients click the link, they are further emailed a secure code they must enter in order to access the form. Patients must enter the code and complete the form before the link expires. When completing the intake form, patients can save their progress without submitting it allowing them to return to it at a later stage. To return to the form, the patient just needs to click on the link in the email again, a new secure code will be generated which they can enter in order to re-access the form.

Previewing the intake form

The intake form cannot be previewed like a normal clinical template. In order to see what your patients will be receiving, we recommend you create a test account and sending the form to yourself.

You can create a new patient by going to Patients > Add patient and can enter as much or as little information as you like. Ensure that you have given your test patient a valid email address that you have access to so that you can receive teh form.

 

 

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