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. 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 request personal details, payment details, funding and referral details, social history information and even attach clinical questionnaires to be completed within your intake form. The intake form is also a great place to record consent to treatment or terms and conditions.

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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. Patients can click or copy and paste the link into their browser to access the intake form. The link expires one week after being sent, so patients must complete the form within that time.

If you send a patient intake form to a patient whose status is set to Blocked, Deleted or Deceased, the link will be invalid unless you change the patient status to something else.

Note

Existing information in the patient's profile will be prepopulated for the patient in the patient intake form. The patient can update this information to overwrite the existing information when they submit the form.

Enabling patient intake forms in your 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).

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  3. At the first radio button option, select Enable.

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  4. (Optional) Configure your other settings as desired:

    • Patient intake forms require 2FA: If you select Yes, patients will be emailed an authentication code that they will need to enter before being able to access the intake form. If you select No, this step is skipped.

    • Send patient online form for online booking: If you select Enable, you can send an intake form to patients automatically when they make online bookings. You can choose from the following options:

      • Send form: Choose whether to send the form on every online booking or only on the patient's first online booking

      • Patient form: Select which intake form to send automatically for online bookings

      • Communication template: Select the email template that is sent with the intake form. The template will need to use the term [Online Form Link]; when you send the email, this dynamic term will expand into a link that patients can click to access the intake form.

  5. 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).

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  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.

  5. In the Description field, enter a description ("e.g. "Brunswick Location Intake Form").

  6. In the Intake Template section, tick the options you want to include as part of the intake form:

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    • Include Patient Details: Tick to ask for name, date of birth, email address, address, phone numbers, and emergency contacts.

    • Request Credit Card details: Tick to ask for credit/debit card information.

    • Credit Card details are mandatory: Tick to make credit/debit card information mandatory. Only visible if you tick "Request Credit Card details".

    • Request Bank Account details: Tick to ask for the patient's bank deposit details. This is the account where the patient receives rebates.

    • Include Social History information: Tick to include your Social History form. Only visible if you have enabled the Social History form.

    • Include Funding Information: If ticked, the patient will be asked for their claim information for each funder you add in Step 6, below.

    • Include Referrer Details: If ticked, the patient will be asked for their referring practitioner's details for each claim they add in Step 6, below. Only visible if you have ticked "Include Funding Information".

      Note

      When patients enter referrer details into the intake form, they are saved as notes under a placeholder referral in the patient's claim under that funder. For privacy reasons, your patients are not shown your list of referrers; you will need to manually link the referrer to the referral on the patient's funding page.

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  7. 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.

    If you include Medicare as one of the funding bodies, patients can also add details for a secondary claimant.

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  8. Click Add Another Template to add clinical note templates or clinical tool templates to the intake form. You will be able to choose from any template you have created or imported. You can reorder the templates by clicking and dragging the icon on the left. Click the red X icon to remove a template from the intake form.

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    Tip

    You can add consent forms as templates to easily capture consent. Halaxy will automatically add a checkbox labelled "I accept the terms listed above" to any clinical note template (but not clinical tool template) you add to your intake form.

  9. Click Save.

RESULT: Your intake form can now be sent to patients, manually or automatically. You can also add additional sections and questions (see below).

Additional sections and questions

Under "Section", you can optionally add questions that are sorted under section headings. Each section will appear as a new page in the intake form. Once the patient submits the form, the answers to these questions will appear as a clinical note in the patient's profile.

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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.

RESULT: Each section will appear as a new page in your intake form. Once submitted, each section will form its own clinical note in the patient's Clinical Notes tab.

Tip

You can rearrange questions within sections by using the up and down arrows.

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