What a build includes

Intake and registration with consent

A new patient registers with your practice, and you can show later exactly what they were told and what they agreed to.

The form collects contact details and a free text message. It does not ask for a diagnosis, a medication list, or anything else a patient might think of as their medical history, because a website form is the wrong place for that. What it does collect is consent: what the practice will use the information for, who will hold it, and how to withdraw, recorded with the date and the wording the patient actually saw.

Anything clinical is handed off to your own system, where it belongs. That keeps personal health information out of plain email, which is the single most common failure we see on practice sites.

What you get

• Contact details and a free text message, and nothing more
• A consent step that records the date and the wording shown
• Routing into your own intake system rather than a shared mailbox
• Labelled fields, keyboard tested, and readable on a phone
• A privacy note beside the form in language a patient can follow

What it does not do

• No form we deliver asks for health information, and the message field asks patients not to include it. Anything a patient does write is routed into your own system, never by plain email.
• It is not a patient record and it is not a substitute for your intake software.
• Consent wording is yours. We draft it and you approve it before launch.

Where it sits. Listed under Signature as online intake forms with consent. See the three build tiers.

Related: The Monograph Standard, Privacy and PIPEDA.