Healthcare-Specific Features

Yes. Add a "Photo Upload" field to your form and configure it with slots like "Front" and "Back":

• On mobile, patients take a photo directly with their camera or choose from their photo library
• On desktop, they upload image files
• Photos are stored securely in AWS S3 and linked to the patient's record
• Displayed alongside their policy details — no manual copying needed by front desk staff

The insurance capture field renders a complete, structured mini-form within your intake form. It collects:

• Insurance carrier name
• Policy number and group number
• Subscriber name and date of birth
• Subscriber relationship (self, spouse, child, or other)

When Patient Mode is enabled, this data is automatically saved to the patient's insurance record. Include two insurance fields for primary and secondary coverage.

Yes. The medications list field lets patients add multiple entries. Each medication captures:

• Medication name
• Dosage (e.g., "10mg")
• Frequency (e.g., "twice daily")
• Prescriber name
• Start date and status (active, discontinued, or as-needed)

Patients click "Add medication" for each entry. All data is normalized in the patient record — structured and searchable, not buried in a free-text field.

The allergies field lets patients list each allergy with structured data:

• Substance or allergen name
• Reaction description
• Severity level — mild, moderate, severe, or life-threatening
• Additional notes

Data is normalized in the patient record with severity levels for clinical triage — much more actionable than a plain text "list your allergies" box.

Yes. The medical conditions field shows a searchable checklist of ~20 common conditions pre-mapped to ICD-10 codes, including:

• Asthma, Diabetes (type 1 and 2), Hypertension, Heart Disease, High Cholesterol
• Arthritis, Depression, Anxiety, GERD, Thyroid Disorders
• COPD, Epilepsy, Migraines, Osteoporosis, Sleep Apnea

Patients check the conditions that apply. Each tracks status (active, resolved, or chronic) and diagnosis date. Patients can also add conditions not on the list.

Add a "Signature" field to your form. The patient experience is simple:

• A signature pad appears where patients draw their signature with a finger (mobile) or mouse (desktop)
• The signature is captured as an image, timestamped, and stored as part of the submission
• Use it for consent forms, HIPAA acknowledgments, treatment authorizations, financial agreements

The signature and timestamp create a clear audit trail for compliance.

The consent field combines rich text and legal acceptance:

• Write custom consent text with rich formatting (bold, italic, links, lists)
• Patients see a required checkbox ("I agree") below the text
• Optionally add a signature pad for signed consent
• A full audit trail records who consented, when, from what device, and their IP address

Use it for HIPAA privacy notices, treatment consent, financial responsibility, photo/video release, and any other agreement.

Yes. The emergency contact field captures structured data:

• Contact name
• Phone number
• Relationship (spouse, parent, child, sibling, grandparent, friend, or other)

Data is saved to the patient record and immediately accessible when needed — no searching through form PDFs.