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The intake form - a guide
The intake form - a guide

Onboard new patients with ease! Real-time responses sent directly to Cliniko (with the fields automatically mapped to the patient fields 😍)

Updated over a week ago

Have you read our intro to Peptalkr forms? Start there if you haven't. If you're looking to learn more about intake forms - you're in the right place πŸ‘ŒπŸΌ

Want to see what our standard intake form looks like?

We can change the questions in any way - use the chat bubble to send us your existing intake form questions, or provide us with your changes.

How the form is sent to clients

You have three options:

1 - with Peptalkr (recommended)

Send it with a Peptalkr transactional email or SMS - instructions

2 - with Cliniko

Send it with a Cliniko reminder SMS or confirmation/reminder email - instructions

3 - with a QR code

If a patient didn't receive the form for some reason, and you want a QR code they can scan on arrival - instructions

How the forms identify the patient

We use variables to identify the patient automatically. Variables add some extra information to the form URL that let us know exactly who is filling it in - namely:

The appointment ID or patient identification number

When you automate sending your form with either Peptalkr or Cliniko, this data is automatically inserted into the URL before it reaches the patient's email/mobile number.

That's why your form URL contains this:


The [appid] part will automatically be automatically replaced by a real appointment ID/patient ID.

If you're adding the form URL to a Cliniko reminder email - be sure to read this article as you'll need to replace the [appid] with Cliniko's version of the variable.

πŸ‘‰ Testing your form? You must replace the [appid] with a real patient ID or appointment ID if you want to test this in action - otherwise your form will not actually be sent into Cliniko. So go ahead and create yourself a test patient in Cliniko, and grab the patient ID from the URL - see the highlighted area below:

Then place that into the [appid] part of the form URL before opening the form in your browser.

e.g. if your form URL is:[appid]&name=[patientfirstname]

It will become this:

Where the form responses go

Provided we have been able to identify the patient, they go straight into Cliniko!

Cliniko fields automatically mapped

Many of the default fields you find in a Cliniko patient file will have their data automatically updated instantly when a form is submitted.

For example - this address field:

Here's a complete list of all fields that can be automatically filled with values from your Peptalkr intake form:

  • Title

  • First name

  • Preferred first name

  • Last name

  • Date of Birth

  • Sex

  • Gender Identity

  • Privacy Policy acceptance

  • Mobile number

  • Email address

  • Address (all fields)

  • SMS marketing opt-in

  • Email marketing opt-in

  • Occupation

  • Emergency Contact

  • Medicare number

  • Medicare reference

  • Referral Source - Referral type (*You must provide us an exact list of your referral sources in Cliniko for this to work properly - read this tutorial).

  • Referral Source - Extra information

Click here to see a list of fields that Peptalkr's won't automatically map to

  • Pronouns

  • Related Patients

  • Other types of phone numbers

  • Time zone (this defaults to your 'account' timezone)

  • Automated reminder type (defaults to your Cliniko account settings)

  • Receives confirmation emails (defaults to your Cliniko account settings)

  • Receives booking cancellation emails (defaults to your Cliniko account settings)

  • Billing information (all fields)

  • DVA card number

  • Reference number

  • Referring doctor

We will be adding more of these fields in the future, but as of now - if you ask these questions, they'll be transferred into the PDF/intake form that is also attached to the patient file.

We do not currently support Cliniko custom patient fields

Additional questions you ask (e.g. health history)

All of your additional custom questions will go into the place you choose - head to the Settings page and choose an option:

πŸ“ Saving format: Treatment note

Note: Treatment notes are only visible to those with the Practitioner or Administrator role. The treatment note will be authored by the Practitioner whose API key you used to set up your Peptalkr account.

If you select this option, the questions will be laid out in this format - with the question in blue, and the answer in black.

You'll also be able to select on the Settings page whether the treatment note is added as a draft or published.

πŸ‘‰πŸΌ Please be mindful that if you have enabled restricted treatment notes in Cliniko, no other practitioners other than the one whose API key you used on the Settings page will be able to view it. We recommend you use PDFs in this instance.

πŸ“Ž Saving format: PDF

Power Receptionists can see these so it's our preferred choice! That way your receptionists can verify that a patient has filled in the form upon their arrival at the clinic or direct them to fill it in if they haven't.

If you select this option, a PDF will be added to the 'Files' section of the patient's file. Open the PDF to view their answers - with questions in bold and answers in regular text.


Can I send you my current intake form?

Absolutely. We'll copy all your questions over to the Peptalkr version of the form and make it look swish.

Can I edit the intake form?

Yep! Simply use the chat bubble to let us know what you'd like to change on the form and we handle it for you.

Can I have more than one the intake form?

Yes! Use the chat bubble to request a new intake form.

What if you can't identify the patient automatically?

If for some reason we can't identify a patient with the appt ID or patient ID, we will search for them by looking for an exact match on their:

  • First name

  • Last name

  • DOB

If we find a match, we'll send the form answers there. If we don't - we'll create a new patient file.

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