Create intake forms using Google Forms

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Why us?

Create HIPAA-compliant intake forms for mental health and therapy. Collect patient history, consent, and eSignatures, and save signed PDFs securely in Google Drive.

Create intake forms easily

Choose form pre-built forms tailored for psychiatry, dermatology, podiatry, optometry, dental, paediatric, physiotherapy and more

Create intake forms easily

Collect patient data

Collect patient data

Capture essential information such as personal details, emergency contact, medical history, symptoms, health goals & more.

Collect files

Make it easier for your patients to upload their insurance or ID cards, Prescriptions, medical records & images when they submit the form

Get informed consent

Get informed consent

Collect patients signatures to get consent for treatment, privacy notice, use of PHI, ensuring compliance with HIPAA privacy regulations

Safeguard PHI

Mark fields as Protected Health informations (PHI) to secure sensitive patient data and limit access to PHI when exporting the data

Prefill intake forms

Prefill intake forms

Securely prefill patients data in form without exposing sensitive data via url, enhancing security and safeguarding patient privacy.

Setup field permissions

Mark the prefill fields as editable readonly or hidden to control customer access & prevent accidental changes in the prefilled form

Setup field permissions

Save and continue later

Save and continue later

Enable autosave to allow patients to save their progress and resume the form at a later time without losing any response

Email form submissions

Automatically mask PHI when sending form responses to email to ensure patient data is not inadvertently disclosed

Email form submissions

Manage patient intake

Manage patient intake

Easily keep track of form submissions using the responses dashboard and improve form completion rates with timely reminders

Google Sheets integration

Automatically sync responses to Google Sheets, providing a familiar interface for organizing and analyzing the data

Google Sheets integration

Google Drive integration

Google Drive integration

Automatically convert form responses into pdf files and sync them to your Google Drive when the patient submit the form

Embed form on your website

Provide a seamless experience for your patients by embedding the forms that matches with your website theme

Embed form on your website

Built for healthcare companies

Add eSignature to Google Forms. Send signed PDF to EHR.

Patient Intake Form

For general

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Psychiatry intake form

For psychiatry

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Medical intake form

For medical

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Chiropractic intake form

For chiropractic

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Dental intake form

For dental

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Optometry intake form

For optometry

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Pediatric intake form

For pediatric

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Physiotherapy intake form

For physiotherapy

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Dermatology intake form

For dermatology

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Podiatry intake form

For podiatry

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Payment Pre-authorization Form

For pre-care

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Patient Payment Form

For post-care

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Customers love us

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user.

Royal Bush, Amaryllis Therapy Network

I am not tech savvy. I chose formesign to help create registration links for clients. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

Sol Evans, Mind Body & Sol

We found in Formesign a perfect solution to collect a big amount of signatures for consent forms in a short amount of time. Our experience was great and the support team was really helpful.

Miquel Faro Palau, Cruïlla Barcelona

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Create intake forms using Google Forms