Schedule Demo
Easily Create Custom Patient Intake Forms For Medical Marijuana Patients
Show and hide sections, add your own questions, add custom disclaimers, add fields for uploading medical records and more
Form Shows Qualifying Medical Marijuana Conditions For Your State Automatically
Show or hide any combination of 4 upload options for the patient’s medical records, ID, photo and proof of residency. You can set the fields as either required or not required and add custom text to the upload option
Add Your Own Custom Questions, Drag & Drop Questions For Order
What Kind of Questions Can Be Added?
- Text: Single row input field for entering text
- Text Area: Multiple row input field for entering text
- Radio Buttons: Fields that allow only one option to be selected
- Check Boxes: Fields that allow one or more options to be selected
- Drop Down Menu: Drop down menu that will allow only one option to be selected
Add Custom Upload Options for Photo, ID, Medical Records & Proof of Residency
Show or hide any combination of 4 upload options for the patient’s medical records, ID, photo and proof of residency. You can set the fields as either required or not required and add custom text to the upload option
Show & Hide Pre-Built Sections For Medical + Social Questions
Pre-Built Form Sections Include
- Medical History
- Medical Questions
- Female Questions
- Social Questions
Add Custom Disclaimers That Create Unique E-signed PDF’s
Add Payments to Your Custom Form
Combine Form With Telehealth & Appointment Web Widgets
