Patient Intake Infrastructure
The intake form below is an example of the patient experience we can deploy directly on a physician or practice website. Patients can access the intake through a simple URL such as YourPractice.com/intake. We can customize the form around your practice’s specifications, required information, appointment types, workflows, payments and scheduling process. Try the demonstration below. Once the patient submits their information, they would be directed into the next stage of the telehealth workflow which is typically the appointment scheduler.
Patient Intake & Appointment
Complete the secure patient intake below to begin your appointment process. Please provide accurate and complete information so your practice can properly prepare for your visit.
Once you finish entering your patient information, please check your email for next steps and scheduling instructions. Depending on your practice’s workflow, you may also be redirected automatically to schedule your appointment, complete additional required information, or submit payment.
Want This for Your Practice?
CHA can build and configure a streamlined telehealth workflow around your practice — including patient intake, appointment scheduling, virtual visits and provider tools.
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