How to Create Intake Form

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    Asked on December 20, 2015 at 01:36 PM

    I'd like to have a form that is both a patient intake form and a health questionnaire/SOAP note exam and treatment form (for which I see a template that will easily serve my purposes - yay!). The other part of what would make my life so much easier in practice is the ability to take information from this intake form - for example, if i have a question for my own assessment about a dog's weight and indicate the dog needs to lose weight - this indication in the form that the dog is overweight, and how overweight (slight to obese) would then kick out a pre-written summary based on that input data into another document that would be given to the client. In the example of weight, if the dog is slightly overweight, the summary paragraph to the client would say - try these low calorie treat ideas instead of standard dog treats, etc etc. If that example is unclear, another would be a data field where I evaluate the dog and indicate muscle mass loss - that when checked off by me as "yes" , it would automatically generate a pre-written list of example exercises for the client to help with strength building. I suppose what i'm looking for is data merging - but I'm not sure if that's the proper terminology. 


    In either case, is this available or possible with JotForm? If a second app is needed, etc, can you let me know what that is? Thanks! :)

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    Answered on December 20, 2015 at 02:01 PM

    Glad to hear that you found a template that will be useful for you. In regards to your other question of the weight of the mascot.

    I am wondering if you want the result to be displayed on the form. This can be done using the show and hide condition. If the user enters an overweight mascot, he would see a result, if not he would see another response.

    I am assuming that you would prefer he gets a notification with the correct response. This also can be done with email notifications.

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    Answered on December 20, 2015 at 02:05 PM

    Hi there - thanks for the prompt reply!


    Would it be possible for the data entered - overweight "yes" for example - to have that answer be entered into a word processing form or pdf? The goal would be to generate a list of "homework" or take-home information about the dog, but not necessarily the whole intake form. 

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    Answered on December 20, 2015 at 03:21 PM

    Thank you for contacting us.

    First, I highly recommend creating your JotForm account (for FREE!). You can use this URL to signup using your email account.

    Currently, I see you are only using Guest account which can be very limited. 

    As to your question...

    Would it be possible for the data entered - overweight "yes" for example - to have that answer be entered into a word processing form or pdf?

    You can achieve this by creating the Custom PDF Report and attach to the Email the PDF result to the end user.

    How to create Custom PDF Report :


    How to Attach PDF on the Notification Email


    Hope this help. Let us know if you need further assistance.