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Intake Forms


This guide is broken down into the following steps. You can run through them in order, or jump to a specific section below:


How Intake Forms Work

You can create an online Intake Form for your entire clinic, a specific discipline, certain practitioners, or an appointment type, to be sent out to your patients when:

  • They book an appointment through online booking
  • They book an appointment directly with your front-desk staff
  • You or your staff manually send the Intake Form

The Intake Form is not automatically sent out: when a patient/client opens an online account through your online booking page. It is also not sent along with the welcome email. Intake Form are strictly attached to appointments.

If more than one Intake Form is automatically triggered as a result of a booking, Jane will combine the Intake Form together for the patient to complete.

Further, if the relevant Intake Form are not completed, Jane will continue to prompt users to fill out the Intake Form on all email communication sent out before the patient’s initial appointment.

Once you have an Intake Form created in your account, you will also see an “Email Intake Form” button in the Patient’s Profile. You will also be given the option to Fill in the Intake Form in Clinic, either by entering their information administratively or by passing a device to the patient. This will load up the Intake Form and lock the patient out of the rest of Jane. The staff member will have to re-enter their password to access Jane’s administrative side.

Jane tells you which versions of the Intake Form the patient has completed, if any are pending, and gives you the option to send any forms, one at a time.

Creating an Intake Form

Looking to really dive in? Check out our Intake Forms Workshop and follow along as we convert a PDF intake form into an Intake Form in Jane!

Jane users with Full Access can find the Intake Forms by heading to Settings > Forms and Surveys, then selecting Intake forms from the options:

Intake Form are made up of five parts: General, Appointment Type, Profile Fields, Questionnaires and Consents.


#1: General

The first tab, “General,” allows you to choose all the details of your Intake Form and determine who gets notified that they should fill it out and when that notification happens.

1- Choose the name of your Intake Form

2- How do you want your Intake Form to be sent out?

  • You have two options:

    • Automatically prompt clients who have not filled out this form
    • Send Manually to each client you’d like to fill it out

3- Choose a ‘Required for’ date

  • You can require that all new patients fill out the Intake Form for their first booking after a certain date even if they have previously filled out an Intake Form.
  • Leave this field blank to not require patients who have already visited the clinic to fill out an Intake Form.

🔥Hot tip: If a form already sent to a patient has a ‘Required for’ date & is deleted for whatever reason (sent accidentally to a patient, etc), the form will be stuck in a Pending state. The clinic will then need to change the form to leave the ‘Required for’ field blank, then the clinic will be able to properly delete the form in the patient’s profile.

4- Choose how long the form is Valid For

  • You can choose to have patients fill out an Intake Form if they haven’t been in for a certain period of time.
  • It’s also good to know that when the same Intake Form is sent to a client, it does not override the first completed form, but creates an additional saved Intake Form each time the client completes it.
  • Once they’ve filled it out, clients will have 24 hours to update the latest Intake Form they are completing.

Note: currently the shortest “Valid For” period we have is 3 days. If your clients are booking appointments more frequently than the 3-day time frame, it’s important to note Jane will not ask them to complete this Intake Form again.

5- Introduction

  • You can also send the Intake Form with a description so that patients know why they are receiving your request to fill it out, the type of information you’ll be collecting, and how it will be used


#2: Appointment Type

Here you can choose which appointments you want this Intake Form to be sent out to.

1- All Appointments

  • This is a ‘clinic-wide’ Intake Form that can go to any client attending an appointment

2- A Specific Discipline

  • If certain disciplines within your clinic have specific needs from their Intake Form, you can choose to send a separate one for clients who have an appointment with a member of that discipline

3- A Specific Staff Member

  • If a member of your staff has specific needs from an Intake Form, you can send a separate form to just their clients

4- Specific Treatments

  • If certain treatments require a specific Intake Form, you can select the exact ones you’d like to send the form before

🔥 Hot tip: If you create a ‘clinic-wide’ Intake Form (by choosing All Appointments), you can also create much smaller ‘discipline/practitioner/treatment-specific’ Intake Forms and Jane will combine them into one form to send to your clients.

  • Be careful not to double up on information if you have clinic-wide questionnaires and specific questionnaires. If you do not have any clinic-wide versions of the form then patients will only be prompted to fill out the relevant assigned questionnaire.


#3: Patient Profile Fields

Check the boxes to include the fields you’d like collected in the Intake Form. These fields will be recorded in the Patient Profile. Any field that Jane already knows will be automatically populated so the patient can either update or just continue on.

You can also choose whether the fields are mandatory or optional. Jane will always ask for First Name, Last Name and Email, but the rest of the fields can be optional or required.


#4: Credit Cards

This feature is available for Jane Payments users in 🇨🇦 Canada and 🇺🇸 the US. If you’re not signed up yet, you can learn more about Jane Payments and get all set up when you’re ready!

Do you want to collect credit cards on Intake Forms to help prevent no-shows (and collect fees when they happen), as well as enjoy a seamless client check-out experience? If yes, then this one’s for you!

Head over to the Credit Cards tab and click the checkbox beside Ask For Credit Card.

We’ve pre-populated some text for you here (you can see how it will appear to clients below), so feel free to change anything you’d like.

1- Preamble:

  • This will appear at the top of the credit card collection page of your Intake Form

2- Cancellation policy:

  • This will appear when your client clicks “Read Cancellation Policy.”

  • ⚠️ Important note! For anyone adding this to an existing Intake Form where you’ve added a customized Cancellation Policy, you’ll need to copy & paste that policy into this box to ensure your clients see the correct policy when adding their credit card info.

2- Declaration:

This is the statement that your client will agree to when clicking the consent box.

You can read all about it in our guide: Collect Credit Cards in Intake Forms.


#5 Collect Client Insurance Information

This will only appear for accounts with insurance features

For those using Jane’s insurance features, there is an additional step that can be enabled to collect insurance information from your clients.

1- Include Insurance Info on Intake Forms

  • You can decide if you’d like this info collected on the Intake Form or not
  • This is useful if you want to collect Insurance Info on your clinic-wide Intake Form, but not the discipline/practitioner/staff-specific ones

2- Insurance Card Image Settings

  • Including this step allows a client to upload images of their insurance card and enter in their policy details for a list of insurers of your choosing
  • The policy details provided by a client in the completed intake form will be converted into an insurance policy that will need to be reviewed and approved before billing

3- Custom Intro

  • You can add any notes about how you work with insurance at your clinic or any other important info for your clients

We have a handy guide about Collecting Insurance Information in Intake Forms that goes into detail on how to enable this step, what your clients will experience, and how to work with the details provided by clients.


#6: Intake Questionnaire

To add in question fields to your form, click the “Questionnaires” tab.

The information you collect in this part of the Intake Form will be saved directly to the patient’s chart. Jane will create a separate chart entry for each Questionnaire that you create. Most practices will find it best to place all the questions within a single questionnaire.

You can build an Intake Questionnaire using the same tools as building a Chart Template - note fields, checkboxes, dropdowns, etc.

You can click the little Rubik’s cube or the Add Item drop-down in the bottom left corner to get started.

  • The Add Item drop-down allows you to quickly select from popular Chart Parts
  • The Rubik’s cube will give you access to individual Chart Parts as well as Chart Templates and the Chart Template Library
    • “Templates” will open all the forms that have been built already within your clinic. Clicking on any of these will allow you to use those forms, exactly as they were built, or you can adjust them to fit your specific needs.
    • “Add from Template Library” brings up a sidebar that allows you to choose from any of the chart templates that practitioners across disciplines have created and shared in Jane’s Chart Template Library.

When using these templates to build an Intake Questionnaire, keep in mind that there are some chart parts that make sense for clinical charting in the treatment room, but not for Intake Forms.

  • Spine, Body Chart, Upload, Vitals, Chief Complaint and Sketch are automatically removed from a template before it is added to an Intake Form in the Questionnaire builder. If you choose a template that has one of these inadmissible components, you’ll see an error message.

After the components are added, you are able to select individual items to edit the contents. This allows you to customize the language, options, and set the field to be required to be filled.

  • You’ll want to name the template/questionnaire something specific so it can be easily found within a Chart Entry (ex. General Health Questionnaire)

Once you have all the components inserted and edited to meet your clinic’s needs, click “Save Intake Form.”

All of the Intake Questionnaires will now show up as a list under Settings > Intake Forms.


#7: Consents

We start you off with a few standard consents but feel free to edit, delete or add as is appropriate for your clinic. If you have a single statement you can leave the “Text” portion blank (like “The above information is true and accurate”), or for a more detailed policy, you can include details in the “Text” area.

Leave the disagree option blank to make agreeing mandatory.

Require Signature Setting

Your clients can even provide an electronic signature when completing their Intake Form by enabling the Require Signature Setting.

We have a handy guide on Requiring a Signature that goes into detail on how to enable this setting, what your clients will experience, and even provides tips and tricks for managing the intake forms of clients who may have already completed their intake form or still have one pending, just in case you collected a few before learning about this great feature. ; )


Preview your Intake Form

From your list of questionnaires (or just one finished questionnaire if you only have one), you can Duplicate, use the up & down arrow to change the order the questionnaires appear in your list, preview a questionnaire you made, or edit them:

Here’s an example of our Intake Form created in our Demo Clinic when clicking “Preview”:

As always, let us know if you need any help!