Description:
Online questionnaire typically used by new patients; helps the provider obtain a detailed picture of a patient's medical history and current medical status.
This form includes the following features:
- Data lookup - Fills in a user's information based on a database search. This form fills in the user's information by searching a SSN database.
- 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.
- Table - An expandable list of items organized into rows. The user can add rows to the table to insert additional information. This table lists medications and dosages.
Support information
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