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Genetic Counseling Intake Form

Asks about reason for genetic counseling, family history of genetic conditions, and ethnic background. Built for genetic counseling clinics.

Questions
10
Page
1
Time
about 3 min

Includes

  • Conditions checklist
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Your practice

Genetic Counseling Intake Form

Live preview. Tap through it like a patient.

Who it is for

  • Genetic Counseling Clinics
  • Prenatal Diagnostic Centers
  • Cancer Genetics Programs
  • Pediatric Genetics Services
  • Reproductive Medicine Clinics

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What's inside

  1. Patient Full NameText · Required
  2. Date of BirthDate
  3. Phone NumberPhone
  4. Email AddressEmail
  5. Reason for Genetic CounselingLong Text
  6. Family History of Genetic ConditionsLong Text
  7. Ethnic BackgroundText
  8. Previous Genetic TestingLong Text
  9. Current Pregnancy StatusLong Text
  10. Cancer Family HistoryConditions

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 Genetic Counseling 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 10 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 Genetic Counseling Intake Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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