formisoft

Emergency Treatment Consent

Asks about known allergies, current medications, and existing medical conditions. Built for emergency department intake and triage consent.

Questions
12
Pages
2
Time
about 3 min

Includes

  • E-signature
  • Consent agreement
  • Medication list
  • Allergy list
  • Conditions checklist
  • Emergency contact
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Your practice

Emergency Treatment Consent

Page 1 of 2 · Your information

Emergency Contact

Live preview. Tap through it like a patient.

Who it is for

  • Emergency department intake and triage consent
  • Urgent care walk-in treatment authorization
  • Workplace injury and occupational health emergencies
  • Pediatric emergency consent from parents or guardians

Formisoft for Pediatrics

What's inside

Before you publish: Add your practice-approved consent wording before publishing.

Page 1 · Your information

  1. Patient NameText · Required
  2. Date of BirthDate
  3. Emergency Contact NameEmergency Contact
  4. Emergency Contact PhonePhone
  5. Known AllergiesAllergies

Page 2 · Additional details

  1. Existing Medical ConditionsConditions
  2. Consent for Emergency TreatmentConsent Agreement
  3. Blood Products AuthorizationLong Text
  4. Authorizing Person RelationshipLong Text
  5. Patient / Authorized Person SignatureE-Signature

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 Emergency Treatment Consent, 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 12 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 Emergency Treatment Consent for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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