Document Template

Automated Patient Intake Form template for healthcare providers.

Send patients a Docuplete link when they book their appointment. They complete the intake interview on their phone before arriving — medical history, current medications, insurance details — all mapped directly into your intake form PDF.

What gets automated

Every field — mapped and validated.

Upload your existing patient intake form PDF. Map each field using Docuplete's visual editor. Common fields for healthcare providers include:

Patient name, date of birth, genderContact details and emergency contactInsurance carrier and member IDPrimary care physician (if referred)Chief complaint and reason for visitMedical history and current medicationsKnown allergiesPatient signature and date
Works with your existing PDF. Docuplete doesn't require a special template format. Upload the form you already use — any standard PDF.

How it works

Set up once. Send a link every time.

1

Upload your PDF

Upload the patient intake form you already use. Any standard PDF works — no reformatting or special software needed.

2

Map the fields

Open the PDF in Docuplete's visual mapper. Drag answer boxes onto each field — client name, dates, signatures — exactly where they appear on the form.

3

Send one link

Generate a unique link for each healthcare client. They complete a guided interview on any device — no account required. You get a completed, signed PDF.

4

Receive the completed form

On submission, the filled PDF is generated, stored in your submission bank, saved to Google Drive, and synced to HubSpot — automatically.

Why it matters

Stop preparing each patient intake form by hand.

No manual data entry

Client answers map directly into the patient intake form PDF. No re-keying, no copy-pasting, no transcription errors.

E-sign with OTP verification

Clients sign electronically in the same session. Identity verified via email OTP — creating a legally defensible audit trail for every submission.

RFC 3161 trusted timestamp

Every signed document receives a trusted timestamp from an independent authority — tamper-proof proof of when it was signed, on every plan.

Google Drive auto-save

Completed patient intake form PDFs are automatically saved to your Google Drive folder after every submission — no manual downloading.

HubSpot sync

Submission data syncs to HubSpot contacts automatically — find or create the healthcare provider contact record and attach the completed PDF.

Full audit trail

Every submission records who signed, when, from which device, and exactly what they submitted — stored independently alongside the document.

Send your first patient intake form in under 10 minutes.

14-day free trial. No credit card. Works with PDFs you already have.

Start free trial

Starts at $69/mo.

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