Intake Bundle Manager

Create and manage groups of intake forms

Bundles

Annual Wellness

3 forms

Psych Follow up

6 forms

Essential + Follow Up

9 forms

Essential Forms

6 forms

Follow-up

6 forms

New Patient

10 forms

Bundle Name

Description (Optional)

Included Forms

3 items

Buprenorphine Treatment Program

Mandatory

Family Medical History

Mandatory

Family Psychiatric History

Mandatory

Available Forms

Patient Profile

Assignment of Benefits

Billing Consent

Confidential Exchange of Healthcare Information

Consent for Diagnosis & Treatment

Consent for Release of Information

CONSENT TO RELEASE RECORDS

HIPAA Consent

Notice of Privacy Practices

Office Policies

PCP Financial Agreement

Scribe Consent

Telehealth Consent

Telepsychiatry/ Telemedicine Informed Consent

Treatment Consent

Insurance Information

Payment Cards

Allergies

Current Medications

Medication History

Vitals (Height & Weight)

Family Medical History

Family Psychiatric History

Hospital & Treatment History

Hospitalization & Treatment

Medical History

Pediatric Social History

Psychiatric History

Smoking History

Smoking Status

Social History

Substance Use History

Surgical History

GAD-7 Anxiety Screening

GAD-7 Screening

Health Maintenance

MDQ-5

MDQ-5 (Mood Disorder)

PHQ-9 Depression Screening

PHQ-9 Screening

UBI-9

UBI-9 Screening

Women Wellness

Women's Health