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Pre-Screening & In-Take Forms

Our mental health pre-screening forms streamline your intake process Premium feature

How long do you spend pre-screening prospective new patients/clients? Initial screening calls (not to mention phone tag!) take an inordinate amount of your time, and the majority of online web forms out there are not HIPAA-compliant. Our secure, HIPAA-compliant patient intake form covers the essential clinical, scheduling, and payment information that therapists and mental health professionals need to know in order to move forward in the screening process.

In addition, your Public Profile is displayed on the same page, making it easy and convenient to show your general availability and information alongside the request form. And, we will time-stamp your availability for you automatically, which prospective patients/clients overwhelmingly prefer when faced with contacting multiple clinicians.

Once a request is accepted, you can streamline the intake process even more by having patients and clients:

  • fill out their own demographic info
  • enter their credit card info
  • book online
  • e-sign policy forms
  • complete rating scales
  • complete questionnaires, which can automatically populate your intake note with one click!
  • and more in the portal

Pre-screening Request Form

Here’s an example of how mental health clinicians can use our pre-screen request form:

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Click/tap the image to zoom-in

Contact us

Groups Pricing

THERAPIST LITE
THERAPIST UNLIMITED
PRESCRIBE LITE
PRESCRIBE UNLIMITED
Pay Annually
(per month, per clinician)

$19

$39

$79

$119

Pay Monthly
(per month, per clinician)

$29

$49

$99

$149

AMA CPT® code annual use license

Prescriber Pricing

ERX ONLY PLAN
PRESCRIBER LITE
PRESCRIBER UNLIMITED
Pay Annually
(per month, per clinician)

$39

$79

$119

Pay Monthly
(per month, per clinician)

$49

$99

$149

Therapist Pricing

ESSENTIALS
THERAPIST LITE
THERAPIST UNLIMITED
Pay Annually
(per month, per clinician)

$0

$19

$39

Pay Monthly
(per month, per clinician)

$0

$29

$49

Monitor clinician & practice quality indicators

Measurement-based care

Practice management reports

Notes per month

Group Practice: Total EMR Cost Comparison

Group practice pricing calculator

Select the number of licenses for your team from each plan to see the subscription cost.

Group practices

Automated chart importing

Unlimited admin assistants

Invoicing + auto-pay

Pre-screen form in public profile

Get started with paperwork quickly!

Additional premium-plan support options

Expand Your Practice with Telehealth

Expand Your Practice with Telehealth

E-prescribing

Custom chart importing

We offer additional help to make importing your data and charts faster and easier.

Insurance claim submissions

Easily submit insurance claims via our partner ApexEDI

Integrate credit card payments into your charts

Live customer support    Chart integration    Portal payments

Together with our partner Bluefin, we offer credit card functionality integrated into your charts, client/patient portal payments, competitive rates, PCI security compliance support, and a human on the other end of the phone if you have questions.

credit card pricing

Contact us or Bluefin directly at 800-675-6573 ext:7802

Custom forms & templates

Hire us to create custom questionnaires and templates for you.

Order labs electronically

Enhanced messaging

Enhanced patient/client portal

Patients/clients can:

Keep your practice in sync

Manages your tasks across your entire practice and every chart

Charts shortcuts

Save time. Let them book online.

Online booking allows your patients/clients to book appointment via the portal for exactly when, what, and where you specify.

Easy-to-use rating scales

Integrated assessment tools with just a few clicks.

Create custom questionnaires

Our questionnaire form builder allows you to create your own forms for your patients/clients to complete.

Create custom note templates

Our form builder allows you to create your own unique note templates for your practice.

E-prescribing

Due to the highly regulated nature of e-prescribing, set up is a multi-step process that includes identity proofing, working with a “trusted assistant” and setting up a second device to give you one-time codes. But don’t worry, we’re here to get you through it…and we promise e-prescribing is a breeze once set-up is complete!