Contents
Custom Forms
Patient Forms can be customized in many creative ways to collect more than just medical history. With various question formats available, you can adapt the forms to fit your practice’s unique needs. This article outlines several common use cases for Patient Forms and explains how to create forms tailored to each. Click here for more detailed instructions about creating your own Patient Forms as needed.
Consent to Treatment Form
To create a form to collect a patient's signature for Consent to Treatment, follow these steps:
| 1 | Go to Settings -> Patient Forms. |
| 2 | Click Create New Form. |
| 3 |
Click Blank to start building from scratch.
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| 4 | Fill out the internal Form Name in the upper lefthand corner. This name will only be seen by members of your practice. E.g. 'Consent to Treatment' |
| 5 |
(Admin Level User Only) Specify whether the completed form requires sign-off from a Provider Level User by checking or unchecking the This form does not require provider sign-off box.
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| 6 |
Give the form a Title and Form Description. Both are visible to the patient. An example would be:
- Title = Consent to Treatment for Horizon Medical
- Form Description = This form explains your treatment options, potential benefits and risks, and your rights as a patient. By signing, you confirm that you understand the information provided and agree to receive the proposed care or procedure.
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Delete the blank section that comes with the blank form by clicking the trash can icon at the right hand corner of the section.
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Click Add predefined section -> Patient Signature.
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Add optional Intro Text as needed. This typically provides context or instructions for the question.
- E.g. Before we begin your care, we want to make sure you understand your treatment options, possible benefits, and any potential risks. Please review the information below carefully, and contact us if you have any questions before signing this form.
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| 10 |
Remove the text Enter the patient agreement and then copy and paste or type your consent terms into the Radio Button Question box. An example would be:
I voluntarily consent to receive medical care, diagnostic procedures, and treatment from Horizon Medical and its healthcare providers. This may include physical examinations, routine testing, and other treatments deemed necessary for my care.
I understand that:
- I have the right to ask questions about any aspect of my treatment.
- I can refuse any procedure or treatment to the extent permitted by law.
- My care team will explain the risks, benefits, and alternatives of recommended treatments when appropriate.
This consent remains valid until I withdraw it in writing.
By agreeing and signing below, I acknowledge that I have read, understood, and agree to the above.
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| 11 |
Review and adjust the default answer options as needed.
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| 12 | Click Save form to save your new form. |
| 13 | Click the back arrow to return to the main Settings page. |
Annual Wellness Questionnaire
To create a series of wellness questionnaires that can be sent to patients prior to annual wellness visits:
| 1 | Go to Settings -> Patient Forms. |
| 2 | Click Create New Form. |
| 3 |
Click Blank to start building from scratch.
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| 4 | Fill out the internal Form Name in the upper lefthand corner. This name will only be seen by members of your practice. E.g. 'Annual PHQ-9 and GAD-7' |
| 5 |
(Admin Level User Only) Specify whether the completed form requires sign-off from a Provider Level User by checking or unchecking the This form does not require provider sign-off box.
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| 6 |
Give the form a Title and Form Description. Both are visible to the patient. An example would be:
- Title = Annual Wellness Questionnaire
- Form Description = These questionnaires ask about how you’ve been feeling over the past two weeks. They include questions about mood, interest in activities, energy levels, worry, and tension. Your answers help us understand your mental and emotional well-being so we can provide the best care for you. There are no right or wrong answers—please answer as honestly as you can.
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Delete the blank section that comes with the blank form by clicking the trash can icon at the right hand corner of the section.
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Click Add predefined section -> Anxiety (GAD-7).
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Click Add predefined section -> Depression (PHQ-9).
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Add optional Intro Text as needed. This typically provides context or instructions for the question.
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| 11 | Click Save form to save your new form. |
| 12 | Click the back arrow to return to the main Settings page. |
Questionnaires for Screening Tools
Use these steps to create questionnaires from screening tools, such as the STEADI 3 fall-risk assessment:
| 1 | Go to Settings -> Patient Forms. |
| 2 | Click Create New Form. |
| 3 |
Click Blank to start building from scratch.
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| 4 | Fill out the internal Form Name in the upper lefthand corner. This name will only be seen by members of your practice. E.g. 'STEADI 3 Fall Risk'. |
| 5 |
(Admin Level User Only) Specify whether the completed form requires sign-off from a Provider Level User by checking or unchecking the This form does not require provider sign-off box.
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| 6 |
Give the form a Title and Form Description. Both are visible to the patient. An example would be:
- Title = Fall Risk Screening
- Form Description = The following questions are designed to identify the risk of falling. There are three simple questions about recent falls, balance, and worry about falling. Your answers help us understand your fall risk and recommend ways to keep you safe. Please answer as honestly as you can.
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Update the Section Title to something you want to use internally. E.g. 'STEADI 3'.
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Specify where you want the responses to export to. E.g. 'Functional'
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Add optional Intro Text as needed. This typically provides context or instructions for the question.
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Click + Add question -> Radio Button List.
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Copy and paste or type the first question of the screening into the Radio Button Question box. An example would be:
- I have fallen in the past year
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Add the predefined answers for the screening into the answer option boxes. Click + to add additional answer boxes if needed. Examples for the first question of the STEADI 3 screening are:
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| 13 | Repeat steps 11 and 12 for each question of the screening. |
| 14 | Click Save form to save your new form. |
| 15 | Click the back arrow to return to the main Settings page. |
Next Step
Create your own Patient Form and share it with your patients!
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