New Patient Intake Form

The New Patient Intake Form is the cornerstone of any healthcare practice's patient onboarding process. This comprehensive template collects everything you need before a first visit: patient demographics, contact information, emergency contacts, insurance details with card upload, current medications, allergies, existing medical conditions, and reason for visit.

Designed for primary care clinics, specialty practices, and multi-provider offices, this form uses a multi-page layout that guides patients through each section without overwhelming them. Conditional logic hides irrelevant sections automatically -- for example, pediatric fields only appear when the patient is a minor.

Every field is HIPAA-ready with proper data handling for protected health information. The built-in e-signature capture for HIPAA consent eliminates the need for separate authorization paperwork. Patients can complete this form on any device before their appointment, saving an average of 12 minutes of in-office wait time.