Query Form

Patient Intake Forms

Patients dislike clipboards and PDFs to complete their patient details. ActiveMD allows consumers to complete all their forms digitally by clicking a link received in a message / mail / or on the website from any device.

patient intake form

Smart Patient Engagement

Digital intake increases customers engagement rates tio as high as 80% with ActiveMD and on some medical intake forms such as prepare for consult it is as high as 98%. Patient portals alone see only a single digit engagement rates.

ActiveMD automates the majority of your patient intake forms creating massive reductions in overhead and errors. Leads to higher customer engagement & satisfaction.

ActiveMD is a smart Practice Platform that enable connected, whole of life care with last mile connectivity into the patients home.

Smart Facts:
  • 5-14% of patients use their patient portal to complete online intake forms
  • 5.1% of medical intake forms come back via the mail
  • Only 9% of patients answer their phone
  • Healthcare apps are only used 2% of the time for online patient intake forms

Medical Intake Form - Captures What You Want

ActiveMD offers Medical forms that are customizable. Appointment type triggers the patient forms to be sent. It all starts with the informed consent follwoed by capturing of problem lists, lab tests and medication history. Allows doctors and medical professionals to focus on care. The patient clicks a link via text/email to interactively complete the online patient intake forms before they arrive. The online intake forms data then gets sent automatically to the integrated PHR/ EHR. The future is here, your patients are going to rave about it.

Give your self the Practice Advantage


Integrated EHR / PHR

ActiveMD PMS - integrates your teams, calendar and PHR into an connected care platform. Customization and linking with all the major EHRs or those that support HL7, API, or SFTP is possible.

ActiveMD has very robust integrated patient record management and tools for ease of physician and create an efficient workflow for care teams.


Branded Experience

ActiveMD offers secure and HIPAA compliant forms which are easy-to-use. The entire electronic patient forms experience will have your company name, logo, and even color scheme to match your brand guidelines.

ActiveMD also provides secure hyperlinks to patient medical forms or patient self-scheduling. Adding a button hyperlink to your website is a very fluid experience for the user.


Rated #1 for Customer Ease-Of-Use

ActiveMD is a push model that uses your appointments to put the patient intake forms you need right into the patient's inbox (text or email). Your patients needs to click a secure link, sign in and then proceed effortlessly to complete their electronic patient intake forms. It's an entirely frictionless systems that your customers AND staff will love. The Patient Portal allows your patents to remain engaged with you.


Everything Else You'll Need or Want

Provides robust workflows for distributed care teams to manage patients remotely. Forms can also set patient statuses automatically if you want to track various pipeline stages through your processes.

Finally, you'll also have access to secure messaging, intelligent reporting, instant technical support for patients and staff and so much more.


Send Almost Anything

Almost any content or medical form you can think of can be turned into a secure link on your website or sent to someone's inbox. The following are some examples: videos, referrals, orders, leads, demographics, insurance, credit card, agreements & consents (e-signature & multi-signature forms), medical histories, satisfaction surveys, treatment plans, income verification, photos, or any other digital content. Introduce patients to your practice, train or educate them on policies and procedures, or anything else you can dream up.


Patient Tool Set And Provider Tool Set

The Patient Portal connect Interface with the EHR is a unique and patented feature. Let patients state and document their problems. You are made aware of these when you login.

This reduces response to changing care needs and modification of care plans. Enables seamless interface and collaborative care with geographically distributed care teams.

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