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Chiropractic Intake Form Template
Add this chiropractic intake form template to your website with 123FormBuilder. Edit the template with simple drag & drop, no coding skills needed.
- Unlimited question fields
- 5.000 submissions per month
- Collect files
- Email & SMS notifications
- Third-party integrations
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Join 1.5 million happy customers that build forms & surveys with 123FormBuilder
Customize template
See howCreate a functional patient database with this pre-designed chiropractic intake form template. It includes pretty much every field you need: contact information, a medical history and details about the patient’s condition, plus a digital signature field. Of course, you can add, modify, edit or remove any fields you want. Just use the drag & drop. Due to a real-time form building platform, you can immediately see any changes you make. And with a theme gallery to choose from, you can have a classy intake form.
Publish template
See howMake your chiropractic intake form available on the web with a simple copy-paste gesture. For instance, take the form code and embed it into a website. Or post the form URL anywhere you want, like an email message or a social media page. Of course, you can even make it available on a tablet in the reception area of your cabinet. Indeed, this chiropractic intake form has a responsive layout that adjusts to any device.
Collect & manage data
See howBuilding your own chiropractic client filing system is more at hand than ever with online intake forms. Furthermore, all that sensitive patient data will reside in a secure database attached to the form. From our platform, you can manage all your form entries. But there’s nothing stopping you from exporting them on your computer as Excel, CSV or PDF files. In addition, we also integrate with the most popular file management apps and CRM systems.
Optimize your flow
See howWith a truly intuitive form building platform conceived to satisfy even non-technical users, you can customize your chiropractic intake form within minutes. Besides, you can set up instant email or SMS notifications to alert you each time someone fills out your form. So give up paper and start saving huge amounts of time with the help of online forms.
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