Online Intake

Form Templates

Easily send and receive your intake forms online. Send clients your online intake forms to fill out on their phone, tablet, or computer. Clients securely sign and submit completed intake forms. Track the progress of new patient intake forms, send automated reminders, and receive completed forms online.
HIPAA PolicyConsent to TreatmentPatient Registration

Template Library

Unlock efficiency and enhance patient care with our extensive template library for streamlined digital forms.
Categories
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Reset All
New Patient Registration
Dental
Medical
Psychiatric
Optometry
Effortlessly gather and organize crucial patient information, streamlining the registration process and ensuring accurate records.
Financial Responsibility
Dental
Medical
Psychiatric
Optometry
Ensure clarity and transparency in financial matters by using our Financial Responsibility form
General Consent to Treatment
Dental
Medical
Psychiatric
Optometry
Actively involve patients in the decision-making process by obtaining informed consent
Notice of Privacy Practices
Dental
Medical
Psychiatric
Optometry
Law
Establish trust and maintain confidentiality by providing patients with a clear understanding of how their protected health information is handled
Medical History Form
Medical
Psychiatric
Efficiently collect and review patients' past medical information, aiding in comprehensive assessments, accurate diagnoses, and personalized treatment plans
Telehealth Consent
Medical
Psychiatric
Optometry
Dental
Promote compliance with regulatory requirements and facilitating secure and convenient virtual healthcare
Cancelation Policy
Medical
Dental
Psychiatric
Optometry
Set clear expectations with our Cancelation Policy form
Medical Records Release Authorization
Medical
Optometry
Dental
Psychiatric
Ensure seamless and secure information exchange between healthcare providers
Generalised Anxiety Disorder Assessment (GAD-7)
Assessments
Psychiatric
Medical
Enabling more accurate diagnoses and facilitating tailored treatment plans for individuals experiencing anxiety-related concerns
Patient Health Questionnaire – Depression (PHQ-9)
Assessments
Medical
Psychiatric
Evaluate and track the severity of depressive symptoms in patients, enabling more accurate diagnoses and guiding personalized treatment.
Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist
Assessments
The Adult ADHD Self-Report Scale (ASRS v1.1) is an 18-item tool for adults 18+ to screen for ADHD symptoms and aid in diagnosis, best used with a clinical interview.
NICHQ Vanderbilt Assessment Scale
Pediatrics
NICHQ Vanderbilt Assessment Scales: Use these tools to evaluate ADHD and behavioral symptoms in children, gathering insights from parents and teachers for a well-rounded diagnosis.

Learn How Zentake Can Help You

Upgrade your intake processes and earn back your valuable time.