Description:
Online patient registration form helps expedite the registration of new patients; reduces the amount of paperwork necessary to add new patients and speeds the check-in process.
This form includes the following features:
- Wizard Pages - Longer forms are separated into multiple pages for ease of use. Page navigation guides the user from one section to the next.
- Date Selector - The user can type a date in the entry field or select a date by clicking the calendar icon.
- Dynamic Sections - Based on user input, these become visible to request additional information from the user.
- Mailing address - Appears if the mailing address is different than the permanent address.
- Medical Insurance - Appears if the user indicates insurance is available.
- Submit Button - Appears when all mandatory fields are completed and the form is signed.
- Click-Wrap Signature button - The user's digital signature using Click-Wrap signing technology.
- Submission Page - Appears after the user clicks the "Submit" button. The user is informed that the form has been submitted.
Support information
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