Creating an effective new patient intake form is essential for any healthcare practice. This is because the form gathers crucial information to deliver personalized, high-quality care right from the start.
Below, we’ll dissect the new patient intake form, explaining what it is and why you should have it in digital form. We’ll end by describing how you can create an effective form that reduces administrative burdens, minimizes errors, and enhances the patient experience.
What is a patient intake form?
A patient intake form is a document healthcare providers use to gather important information from patients before giving them an appointment with a healthcare provider. There can be different intake forms for new patients and existing patients. The form handed over to new patients is called a new patient intake form.
This form generally includes fields for gathering personal information, medical history, current medications, allergies, insurance details, etc. For specific treatments, a consent section is involved as well. This form is generally more comprehensive than the form for existing or returning patients.
The primary purpose of the new patient intake form is to ensure that the healthcare provider thoroughly understands the patient's health status and needs. This allows them to provide more accurate diagnoses and personalized care plans. New patient intake forms also help streamline the administrative process, reduce wait times, and improve the overall efficiency of the healthcare practice.
What are the benefits of a digital patient intake form?
Like any form, a patient intake form can be digital or physical. In comparison to traditional physical forms, digital patient intake forms offer multiple benefits:
- Enhanced accessibility: Patients can fill out the forms online before their appointment, saving time and allowing them to complete the form at their convenience.
- Better data management: Digital forms allow for easy storage, retrieval, and updating of patient information, facilitating efficient record-keeping.
- Enhanced data accuracy: Digital intake reduces errors and provides clinicians with more comprehensive and actionable clinical data.
- Improved patient and staff satisfaction: Addressing time-consuming processes can improve both patient and staff experiences.
- Increased security: Digital forms can include encryption and other security measures to protect sensitive patient information.
How to create a new patient intake form with Google Forms
Step 1: Create a new Google Form
Navigate to your Google Forms.
Click on the ‘Blank form’ button to start a new form.
Title your form appropriately and offer a helpful description for the patients filling the form.
Step 2: Add fields for the patient’s basic information
Now, you can start adding questions to gather essential patient information.
Edit the default untitled question to gather the patient’s full name. Then, click the button next to the question field to change the ‘Multiple-choice’ question format to ‘Short answer.’ Open-ended question formats are going to be important for filling out personal info.
Click on the ‘Add question’ button in the floating menu to add other questions:
- Date of Birth
- Gender
- Address
- Phone Number
- Email Address
- Primary Insurance Provider
- Policy Number
- Policyholder's Name
- Relationship to Policyholder
- Policyholder’s Date of Birth
- Primary Care Physician
- Preferred Pharmacy
Google Forms offers a wide range of question formats. For questions like ‘Date of Birth,’ try using the ‘Date’ question format.
Step 3: Include areas to inquire about medical condition
Next, you can move on to collecting information about why the patient is visiting your healthcare facility. These could include the following categories:
- Reason for Visit
- What is the primary reason for your visit today?
- Describe any symptoms you are experiencing.
- When did these symptoms begin?
- Have you experienced these symptoms before? (Yes/No)
- Pain Assessment
- Are you experiencing any pain? (Yes/No)
- If yes, please describe the pain (location, intensity, type, etc.).
- How would you rate your pain on a scale of 1 to 10?
- Additional information
- Do you have any chronic or ongoing medical conditions (e.g., diabetes, hypertension, asthma)?
- Are you pregnant?
- Are you allergic to any medication?
Each category is critical for obtaining information that helps deliver timely and appropriate care to patients. It’s always advisable to have multiple-choice questions wherever you can to make the form-filling process easy and quick for patients.
Step 4: Add a place for an emergency contact
You may also want to add questions to gather information about your patients' emergency contacts now. This includes questions like:
- Emergency contact’s full name
- Relationship to patient
- Phone number
- Alternate phone number
Choose the short answer question format for all these questions.
Step 5: Allow patient to upload pertinent files
The next thing to include in your patient intake form is a place for them to upload files like diagnostic lab reports.
To do this, add a new question and choose the ‘File upload’ option with the button next to the question field.
Click ‘Continue’ in the next window.
Then, set the criteria for the types of files that the patient can upload.
Keep this question ‘Required’ if you anticipate and require all new patients to upload files, or else toggle the ‘Required’ button off. With that, your new patient intake form is complete!
Step 6: Use Form Publisher to automatically create document
Now that you’ve created the form, why not make the next step easier, too? Download Form Publisher so that every time a new patient fills this form, it automatically gets converted into a document in your preferred format, such as a PDF. Then, you can pass it on to the attending physician, keep digital copies safely in your records, and even pass off copies to other departments of your practice as needed.
Form Publisher can help you create new patient intake form PDFs
That’s what Form Publisher does! It takes filled forms and arranges the data to automatically create professional documents in multiple different file formats, including PDFs. This makes it easy to manage the form responses you receive.