Several questions

I would like to survey patients who receive a specific procedure.

On the day of the procedure they complete a brief registration form with their unique identifier number and their contact info (preferably mobile phone # but could be email).

I would automatically like to send a survey form to patients who received the procedure on days 1, 3 and 7 following the procedure.

Is it possible to do this sort of thing with JotForm?

Thank you,

Art Bergh

Hello! Please find answers to your concerns below:

- On the day of the procedure they complete a brief registration form with their unique identifier number and their contact info (preferably mobile phone # but could be email).

Creating such registration form is possible with JotForm. We have drag/drop interface using which you can easily create your form with these fields.

To know how you can create your from, please read: how-to-create-your-first-web-form

- I would automatically like to send a survey form to patients who received the procedure on days 1, 3 and 7 following the procedure.

You can create three autoresponders and set these to be sent after 1, 3 and 7 days respectively. Content of these autoresponders is customizable; so in these autoresponders; you can put in the link to your survey form which your users can then click and complete.

Autoresponders are the email alerts which are sent to the users who complete the forms; these autoresponders usually consist of the data that they submitted; but it is customizable.

Please check this form: https://form.jotform.com/210721511970043

Based on the value provided for the 'Date of Procedure' field, the other dates are calculated. We can use these calculated dates for setting the delivery date of our auoresponder emails.

Adding dates is easy with JotForm; in this form, I've used the CALCULATE conditions to find other dates based on the user provided date (as indicated in the screenshot below).

• This is how you can create an autoresponder email: setting-up-an-autoresponder-email
• This is how you can edit the autoresponder email content: how-to-edit-the-email-template-for-notifications-and-autoresponders
• This is how you can configure your autoresponder emails to be set at a later date: send-emails-later-using-autoresponder-email
• In case you wish to keep the extra date fields hidden on your form; you can do so by following these instructions: how-to-hide-form-fields

I hope this makes sense. If you have any questions, let us know.

Thank you!