Edit Intake Form

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    Asked on August 02, 2019 at 04:22 PM


    Currently when a patient signs the intake form, they see this statement right before the signature.  We would like this statement to carry over on their signed copy that we receive.  Can you assist me?

    Statement needed to be included in final copy of signed intake form:


    I understand that Dr. Ian Cholewa is a Naturopathic Physician licensed in the state of Hawaii. That he has extensive training in the use of Electrodermal Testing Instruments and is using the data from these tests to investigate a functional assessment of my condition, (not a pathological diagnosis). That the collection of these data may be used in research being conducted by the AANP (American Association of Naturopathic Physicians) position paper titled Electrodiagnosis in Naturopathic Practice under the bylaws of the AANP.

    Thank you,

    Leslie Feldt

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    Answered on August 02, 2019 at 05:40 PM

    Hi Leslie!

    If you would like to include the text of consent in the notification emails, you can edit the body of the notification emails to include the text. Simply go form Settings>Emails>click on the orange Pencil icon to edit>scroll down to insert a new row just above the signature field and paste the text of consent. After that, click the green Save button.


    To be able to see the text of consent on your Submissions page, please select the form on My Forms page>click More>View Submissions. Once on the Submissions page, please click on the gray Gear button in the top right corner and check the Show Headers and Texts checkbox.

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