VIEW DEMO Introductory Offer $19.98

Is your waiting room really the best place for patients to fill out intake forms? What if your patients could fill out intake forms from the comfort of their own home, office, or even parking lot?


ChiroIntake is designed to capture standard questions that new patients in a typical chiropractic office answer. ChiroIntake captures patient demographics, insurance, complaints, medical history, automobile accident information if necessary, and outcome assessments like Oswestry or Neck Disability.


Once completed by the patient, your office will receive an email with the information in a nice tidy report. Now when the patient arrives in your waiting room, all they do is sign your HiPAA and consent forms, and they're done.

IT'S EASY AS 1,2,3!

Sign Up

Sign up is quick and easy. Takes less than 10 minutes.


Link Up

Add the custom link, that we supply, to your website.


You're Up

Start receiving email reports to your office. Tidy reports with all of the information that was filled out by your patients.


Convenient

Patients can fill out the intake forms at their own convenience. On their laptop, desktop, tablet, or phone.

Accurate

Leave the guess work to the magicians. Chiro Intake lets the patients fill out the forms electronically, making the information going into your EHS more accurate.

Efficient

Streamline the flow of your office. Using Chiro Intake lets you do more patient care, and less paperwork.


Button Examples

Here are some examples of buttons that would go on your website.





What makes ChiroIntake so good?

Once completed by the patient, your office will receive an email with the information in a nice tidy report. Now when the patient arrives in your waiting room, all they do is sign your HiPAA and consent forms, and they are done.


VIEW DEMO


Desktop Computer
LEARN MORE

Cellphone
LEARN MORE

Tablet
LEARN MORE

What We're About

Improve the efficiency of your practice with chirointake.com. Our patient intake form system dramatically improves your practice by giving your patients to fill out medical forms on their own time before they come into the office. Chirointake allows your patient to skip the waiting room, improving the workflow of your office. It also improves the accuracy of the information going into your EHS system. And gives your front desk staff more time to complete important tasks.