Patient intake form builder
Most intake forms collect an address and miss the five questions that decide whether the patient should be in your room at all. Edit the wording, print the packet, keep the screen.
Ask the screening questions on paper
Asked aloud in a busy room, red-flag questions get skipped and get soft answers. On paper the patient answers them alone, and there is a record that they were asked. That record is worth more on a bad day than every other line on the form.
Red flag — refer out
Saddle anaesthesia with bladder or bowel change is a same-day referral, not a re-book. Unexplained weight loss with new back pain in a patient with a cancer history is the same. The form finds them; the clinician acts on them.
Consent people actually read
Informed consent that runs to two pages of small print is not informed. Name the technique in plain words, name the common reactions and the rare risks, and say the patient can stop. Keep it to a paragraph they will finish.
Ask what they want back
“What is the one thing you most want back?” is the most useful question on the page. It gives you the functional goal that goes into the plan of care, the wording for the discharge criterion, and — usually — the reason the patient stays.
This tool builds a blank form. Nothing typed into it is stored or transmitted; do not enter real patient details here.
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