Stop Chasing Paper. Start Treating Patients.
Create secure, mobile-friendly intake forms in minutes. Patients fill them out on any device before they arrive. You review submissions from your dashboard.
Free plan available · No credit card required · 14-day trial on paid plans
Adult Patient Intake Form
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Personal Information
Insurance
Everything you need for digital patient intake
Built for medical practices that want to eliminate paper forms, reduce errors, and give patients a better experience.
Drag-and-Drop Form Builder
Build custom intake forms with pre-built medical sections. 9 field types including text, date, select, radio, checkbox, and masked SSN.
HIPAA-Compliant Security
Field-level AES encryption, comprehensive audit logging, and role-based access controls protect every piece of patient data.
Mobile-Responsive Forms
Patients complete forms on any device via a simple URL. No app download or login required. Auto-save preserves their progress.
Admin Dashboard
View, search, and manage all form submissions from a centralized dashboard. Mark submissions as reviewed and export data.
Multi-Practice Support
Manage multiple providers and locations with role-based access control. Each practice gets isolated, secure data storage.
Webhook Integrations
Connect to any system with webhook infrastructure. Automatically push submission data to your existing tools and workflows.
Up and running in minutes
Three simple steps to digitize your patient intake process.
Create Your Forms
Use the drag-and-drop builder with pre-built medical sections. Choose from 9 field types and customize everything to match your practice.
Share With Patients
Send patients a simple URL before their appointment. They fill out forms on any device — no app, no login. Auto-save protects their progress.
Review Submissions
View completed forms in your admin dashboard. Search, filter, mark as reviewed, and trigger webhooks to your existing tools.
See the patient experience firsthand
Try our interactive demo form to experience exactly what your patients will see. Clean, professional, and designed for healthcare.
- Mobile responsive — works on any device
- No patient login or app download required
- Auto-save preserves progress automatically
- 9 field types including masked SSN input
- HIPAA-compliant data handling
New Patient Registration
Contact Information
Built for your specialty
Pre-built form sections designed for the specific needs of your medical practice.
Optometry
Streamline eye care intake with specialized forms
- Vision history and family eye health forms
- Insurance verification intake
- Contact lens questionnaires
- Pre-visit symptom screening
Dental
Comprehensive dental patient onboarding
- Dental history collection
- Treatment consent forms
- Insurance and payment capture
- New patient registration
Dermatology
Specialized skin care intake workflows
- Skin condition history intake
- Medication and allergy tracking
- Photo consent documentation
- Procedure pre-screening forms
Simple, transparent pricing
Start free. Upgrade when you're ready. All paid plans include a 14-day free trial.
Free
Get started with the basics
- 1 form
- 50 submissions/month
- Community support
- HIPAA-compliant encryption
- Mobile-responsive forms
Starter
For small practices getting started
- 5 forms
- 500 submissions/month
- Email support
- Custom branding
- All field types
- Auto-save for patients
Professional
For growing practices
- Unlimited forms
- 5,000 submissions/month
- Priority support
- API access
- Webhook integrations
- Role-based access control
Enterprise
For multi-location organizations
- Unlimited everything
- White-label solution
- Dedicated support manager
- Custom SLA
- SSO integration
- Onboarding assistance
Frequently asked questions
Everything you need to know about PatientForms.io.
Still have questions? Reach out to our team
Ready to eliminate paper intake forms?
Join our early access program and be among the first practices to modernize patient intake. Start with a free plan — upgrade when you're ready.
- Free plan available — no credit card required
- HIPAA-compliant from day one
- Set up your first form in minutes