Creating intake forms can be a tricky process! With so many fields and variables to add, you could be stuck for hours at your computer trying to get it done.

We make it super easy for you - we've created an intake form template that asks all of the important questions you need to know about your patient, as well as a range of questions about their current circumstances.

To view a copy of the Standard patient intake form click here.

  • It works on mobiles, tablets, laptops and desktop computers.
  • It's a step by step format that guides the patient through each question.
  • The questions populate based on previous answers.
  • Questions don't suit you? No problem. Contact us with your required changes and we'll update the form for you. You can send your existing NP form in PDF/Word format, or simply request removals/additions to our default form. All of this can be sent by using the chat bubble in the bottom right of screen.

☝️ Cliniko's inbuilt Patient Forms are not yet available in the Cliniko API - meaning integrators (like us!) can access/amend them just yet. This will be coming soon, but until then we have our own special intake form you can use.

Do fields map directly to the corresponding fields in Cliniko?

Yes! The following fields will map directly to Cliniko fields:

  • Title
  • First name*
  • Last name*
  • Date of birth*
  • Mobile number
  • Email address
  • Address
  • Occupation
  • Emergency contact
  • Medicare number
  • How did you hear about us
  • SMS marketing opt-in

*These 3 fields are used to search for the patient in Cliniko. If there is a match, all other fields will be updated with what they've typed into this form. If no match is found, a new Patient will be created with this information. If a patient accidentally misspells their name or DOB a new patient will be created. You can, however, merge two patients in Cliniko if this happens.

All other fields in the form are added to the Patient profile as a Treatment note. The name of the note will be Peptalkr Intake Form and it will be published by whichever Practitioner you used to create the API key you used to set up Peptalkr.

How do I set up my intake form?

Once you have filled in your settings and our team have emailed you to let you know your account is ready, you can click on the Forms tab

What if I want a custom form?

No problem, you just need to contact us and our team will gladly customise your intake form to your specific requirements. Just send us your existing intake form/s and we'll set them up for you.

Can I have more than one form?

If you are on an Unlimited plan then we will create any number of forms you need! Just send us your forms and we'll do the rest. 🚀

Can I add a policy acceptance/waiver to my form?

Yes - but we cannot take legal signatures at this time. You'll need to get signatures on paper (or some other application) until we introduce this feature.

Can I use patient forms I created with another platform?

Yes, as long as there is a public link to the form then you can use any patient form building service. Simply paste the link to the form into your email/SMS templates. If you have several forms - that's no problem. You can create different email/SMS targeting the correct patients for each form. Finger Ink is a popular form-creation app (that we love) and can be used with Peptalkr easily.

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