You can create an online intake form for your clinic or for specific disciplines or practitioners 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 forms are strictly attached to appointments.
If your patient has booked an appointment, but has not yet completed the relevant intake form, Jane will continue to prompt users to fill out the intake form on all 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 of the versions of the intake form the patient is eligible to complete and gives you the option to send them all or just one at a time.
Creating an Intake Form
Jane users with Full Access can access the form-building area in Settings. There is an “Intake Form” area on the left-hand side. Intake forms are made up of four parts: Settings, Profile Fields, Questionnaires and Consents.
The first tab, “Settings,” 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.
First, choose the name of your Intake Form:
When do you want your intake form to be sent out? You have two options:
1 - Automatically prompt patients who have not filled out this form
2 - Send Manually
For which disciplines do you want this form to go out? You can choose “All” or any of the other disciplines you have set up will appear in the drop-down arrow:
For which staff members do you want this form to go out? You can choose “All” or any single staff member:
If you have a clinic-wide form (by choosing “All” for both “Discipline” and “Staff Member”) this version of the form will be sent to every patient, and then you can add discipline or practitioner additions. So be careful not to double up on information if you have a clinic-wide questionnaires as well as specific questionnaires. If you do not have any clinic-wide versions of the form then patient’s will only be prompted to fill out the relevant assigned questionnaire.
The next area is important to understand. If you would like ALL PATIENTS (not just first-timers to be prompted to fill in the questionnaire as of a certain date you can set that here. If it’s blank then it will just be new patients to the clinic or practitioner that are automatically asked to complete the form.
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.
You can choose to have patients fill out an intake form if they haven’t been in for a certain period of time.
And you can 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. Patient Profile Fields
You can choose which parts of the patient profile you would like to collect directly from your patient. Just check the boxes to include that field 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 as is appropriate.
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.
3. Intake Questionnaire
From the “Intake Form” tab unders your clinic’s Settings, click the “Questionnaires” tab.
The information you collect in this part of the intake form will be saved directly to the patient’s chart as their first chart entry. The name you choose will display in the patient’s chart and is how you will be able to identify the form. Therefore, you’ll want to name this part of your form something, such as “General Health Questionnaire,” so it can be easily identified amongst your other chart entries.
You can build an intake questionnaire using the same tools as building a chart template - note fields, check boxes, drop downs etc.
You can either use the drop-down arrow for quick access to the questionnaire parts:
Or, you can click “Add Item” for more options:
A form builder will appear where you can see all clickable icons representing all the individual parts you have to choose from to build your questionnaire. You’ll also see options at the top that will help you build the questionnaire using templates:
“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 like this:
Simply click “Yes, Continue,” to open the remaining components of the template and carry on building your intake form.
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.
One note on building questionnaires: 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.
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.
And a note on consents with checkboxes:
There is certainly debate about what constitutes the electronic equivalent of the pen to paper signature. The intake form is designed to be filled out at home, and is submitted using the patient’s email address. In this case, the fact that they are logging in to their email account is the identity verifier. But I understand the familiarity with the visual signature. At Jane we do recommend that you consult your association or governing body about the nuances of obtaining consent from your patients.
Preview & Other Features
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:
As always, let us know if you need any help!