This comprehensive new patient intake form is perfect for clinics that accept insurance and provide integrative, primary care, or functional medicine services. It includes sections for insurance details, medical history, pharmacy preferences, allergies, medications, social and family history, HIPAA consent, payment policies, and a medical arbitration agreement. Patients can provide emergency contacts, authorize treatment, and acknowledge financial responsibility—all in one professionally designed, easy-to-use packet.
Download now to streamline your intake process, protect your clinic legally, and collect all essential patient and insurance info up front.