Got a paper form?

Scan it with your phone. We fill it in, you email it to the office. No pen required.

Have a photo already? Upload it

1

Scan the paper form

2

We fill in your kid's info

3

Email it to the office

Finding the questions and filling in Jackson's saved info...

Filled in for you

Check it over. Anything we didn't have saved is highlighted.

Patient Intake Form

Scanned form

Sign with your finger. We'll add it to the form before it goes out.

×

Sign above the line

Dated

Signed by

Email the finished form straight to them. Or save it to print.

Office email

On your phone, "Email the form" opens your mail app with the filled PDF attached, just add the office address and hit send.