Intake Note
Comprehensive new-patient intake capturing presenting concerns, complete history, social needs, screenings, patient goals, and the initial plan.
Included on every plan, including Free.
- Choose this templatePick it when you start a visit, or make it your default.
- Record the visitIn the room, over telehealth, or by dictation afterwards.
- Review, edit and signThe draft arrives in these sections, ready for your review.
What’s in this template
15 sections, in the order they appear in the finished document.
- 1Reason for VisitParagraph
- 2Presenting ConcernsParagraph
- 3Prior Care & RecordsBullets
- 4Past Medical & Surgical HistoryBullets
- 5MedicationsBullets
- 6AllergiesBullets
- 7Family HistoryBullets
- 8Social History & Social NeedsBullets
- 9Functional StatusBullets
- 10ScreeningsBullets
- 11Review of SystemsBullets
- 12Physical ExamAuto
- 13Patient Goals & PreferencesBullets
- 14Assessment & PlanAuto
- 15Follow-UpBullets
“Auto” sections use whichever format reads most clearly for what was discussed: prose or a list.
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