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Behavioral Health Intake Form

Asks about have you ever been diagnosed with a mental health condition, are you currently taking any medications for mental health, and have you experienced any of the following symptoms. Built for community mental health centers and behavioral health agencies.

Questions
8
Page
1
Time
about 2 min

Includes

  • E-signature
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Your practice

Live preview. Tap through it like a patient.

Who it is for

  • Community mental health centers and behavioral health agencies
  • Outpatient substance abuse and dual-diagnosis programs
  • Integrated behavioral health in primary care settings
  • Court-ordered and mandated behavioral health treatment

Formisoft for Mental Health

What's inside

  1. Full NameText · Required
  2. Date of BirthDate · Required
  3. Have you ever been diagnosed with a mental health condition?Long Text · Required
  4. Are you currently taking any medications for mental health?Long Text · Required
  5. Have you experienced any of the following symptoms?Checkbox · 6 choices · Required
  6. Do you have any history of substance use?Long Text
  7. Is there anything else you would like to discuss?Long Text
  8. SignatureE-Signature · Required

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Behavioral Health Intake Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 8 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Behavioral Health Intake Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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