Patient Intake

The form is the easy part.
Knowing who is waiting is the product.

Most practices have solved digital intake in the narrow sense. There is a PDF, or a portal, or a form somewhere on the website.

What they have not solved is what happens next. A patient finishes their paperwork on a Tuesday night. It lands in an inbox, or a folder, or a fax queue. Someone will get to it.

On a busy week, someone does not. Eleven days later that patient has booked somewhere else, and nobody at the practice ever knew there was a patient to lose.

Book an Assessment See the queue

The part that matters

Not a list of forms.
A list of people nobody has called.

Every practice already has an overdue pile. Almost none of them can see it.

Sample data, and it is live. Every name, date and detail below was made up for this page. Open a row to see what your staff would see, and mark one contacted to watch the counters move. There is no connection to any real system and nothing you click is saved or sent.

portal.example-practice.com/intake
6
Not contacted
3
Waiting over 24 hours
11
Contacted today
1,204
Total all time
PatientLocationSubmitted WaitingStatus
Age
48
Visit type
New patient
Location
Northside
Submitted
Aug 6, 7:42 PM
Reason for visit
Right shoulder, ongoing
Current medications
Lisinopril, atorvastatin
Scheduling preference
Weekday mornings
Records release
Requested from Cascade Medical Group
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
35
Visit type
New patient
Location
Northside
Submitted
Aug 6, 9:15 PM
Reason for visit
Lower back, after a fall
Current medications
None reported
Scheduling preference
Any afternoon
Records release
Not requested
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
61
Visit type
Returning
Location
Eastgate
Submitted
Aug 7, 6:30 AM
Reason for visit
Follow-up, knee
Current medications
Metformin
Scheduling preference
Tuesday or Thursday
Records release
Already on file
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
29
Visit type
New patient
Location
Northside
Submitted
Aug 7, 8:12 PM
Reason for visit
Wrist, work injury
Current medications
None reported
Scheduling preference
Weekday mornings
Records release
Requested from Harbor Occupational
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
44
Visit type
New patient
Location
Eastgate
Submitted
Aug 8, 6:55 AM
Reason for visit
Neck and headaches
Current medications
Sumatriptan
Scheduling preference
Late afternoons
Records release
Not requested
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
52
Visit type
Returning
Location
Westfield
Submitted
Aug 8, 8:20 AM
Reason for visit
Annual physical
Current medications
Levothyroxine
Scheduling preference
Any morning
Records release
Already on file
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
38
Visit type
New patient
Location
Northside
Submitted
Aug 8, 7:05 AM
Reason for visit
Ankle, sports injury
Current medications
Ibuprofen as needed
Scheduling preference
Weekends if available
Records release
Requested from Summit Ortho
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Age
27
Visit type
New patient
Location
Eastgate
Submitted
Aug 7, 5:40 PM
Reason for visit
Routine new patient visit
Current medications
None reported
Scheduling preference
Any weekday
Records release
Not requested
In the real portal this record is encrypted at rest, decrypted only for staff with access, and every open is written to the audit log. This page does none of that. The fields above are invented, held in the page you are reading, and sent nowhere.

Step through the form the patient fills out before it lands here.

Three of those people filled out your paperwork more than a day ago and have heard nothing. That is the whole product. Not the form, not the encryption, not the integration. The number in red.

Staff open the queue, see who has been waiting longest, call them, and mark them contacted. The overdue count goes down. When it does not go down, you find out on the same day instead of at the end of the month.

What the patient does

Seven steps. On their phone. Before they arrive.

Encrypted end to end. No app to install, no account to create, no clipboard in the waiting room.

01
Location and provider

Routed correctly from the first tap, which matters once you have more than one site.

02
Patient information

The demographics your front desk would otherwise retype off a paper form.

03
Medical history

Completed at home, where people actually remember their medications.

04
Records release

Requested up front rather than chased after the first visit.

05
HIPAA acknowledgment

Captured and timestamped, so it is not a signature nobody can find later.

06
Consent

Same, recorded against the submission rather than filed separately.

07
Scheduling preference

When they can actually come in, so the callback is a booking rather than a game of phone tag.

In production

234 intakes processed.

Running in a live deployment, not a prototype. Every submission encrypted, queued, and visible to staff the moment it lands.

Where it connects

What gets captured here gets billed later.

A field entered wrong at intake becomes a denial six weeks later, by which point nobody remembers where it came from. Billing Intelligence traces that backwards and tells you which intake field is costing you.

And the patients arriving through this queue are the ones Local Search found in the first place.

See all six agents →

Find out how long your pile has been sitting.

Thirty minutes, no obligation. Most practices cannot answer that question, which is usually the answer.

Book an Assessment