AI intake form auto-fill. More listening.
Fill your clinic’s intake PDF from encounter context. Bring visit details into the right fields, make your edits, and export your form.
No credit card required. Start with the free plan.
Bring your form
Your clinic’s PDF
Capture their story
Details mapped to fields
Make it yours
Edit and export
Your form. A familiar start.
Upload the fillable PDF your clinic already uses. Match visit priorities, preferences, and patient goals to your form’s fields.
- Use your existing fillable PDF
- Save templates for repeat visits
- Bring encounter details into the right fields
From a blank form to a patient-specific draft.
Compare the fields. See the patient statement behind each detail.
In the patient’s words
“This is my first appointment. I spend most workdays at my desk, and I’d like to get back to swimming. Afternoon appointments work best for me.”
- Visit type
- Daily routine
- Preferences
Same form. Before and after.
Patient intake form
New patient intake
J. Morgan · First appointment
- Visit type
- First appointment at the clinic.From the conversation
“This is my first appointment.” - Daily routine
- Most workdays are spent at a desk.From the conversation
“I spend most workdays at my desk.” - Patient goal
- Get back to swimming.From the conversation
“I’d like to get back to swimming.” - Appointment preference
- Afternoon appointments.From the conversation
“Afternoon appointments work best for me.”
Ready to edit and export
In the patient’s words
“My last visit was in September. This time I’d like to talk through my daily routine and set goals for the next month. Mornings are easiest, and email is the best way to reach me.”
- Previous visit
- Visit priorities
- Preferences
Same form. Before and after.
Patient intake form
Follow-up intake
A. Lee · Next appointment
- Previous visit
- September.From the conversation
“My last visit was in September.” - Visit priorities
- Discuss daily routine and goals for the next month.From the conversation
“Talk through my daily routine and set goals for the next month.” - Appointment preference
- Morning appointments.From the conversation
“Mornings are easiest.” - Contact preference
- Email.From the conversation
“Email is the best way to reach me.”
Ready to edit and export
In the patient’s words
“I walk the dog most evenings and enjoy weekend hikes. I’d like to make more time for outdoor activities. Weekend appointments fit my schedule best.”
- Daily activities
- Patient goals
- Preferences
Same form. Before and after.
Patient intake form
Activity & goals intake
R. Patel · First appointment
- Daily activity
- Walks the dog most evenings.From the conversation
“I walk the dog most evenings.” - Interests
- Weekend hiking.From the conversation
“Enjoy weekend hikes.” - Patient goal
- Make more time for outdoor activities.From the conversation
“I’d like to make more time for outdoor activities.” - Appointment preference
- Weekend appointments.From the conversation
“Weekend appointments fit my schedule best.”
Ready to edit and export
Need a blank form? Start with this one.
A simple patient intake template you can type into or print. Adapt it to the information your clinic needs.
- Patient details
- Visit priorities
- Previous visits
- Visit preferences
- Patient goals
- Additional notes
1 page · 11 fillable fields · No account required
To auto-fill a form from an encounter, bring your fillable PDF into Vero Documents.
Vero
Fillable PDFPatient intake form
A starting point for your clinic’s workflow
Patient name
Date of birth
Visit date
Contact details
Reason for visit & priorities
Previous visits
Appointment & contact preferences
Patient goals
Type into the PDF or print a blank copy
Your details. Your finished form.
Visit priorities, personal goals, and appointment preferences in one place. Edit the fields and export a form that fits your workflow.
- Add visit details and preferences
- Use your own wording
- Export for your clinic’s workflow
Frequently asked questions
What type of intake PDF can I upload?
Upload a fillable PDF to Vero Documents. Vero maps available session information to the form’s fields, and you can save the form as a reusable template.
Which patient details can populate the form?
Vero maps encounter details to your PDF fields, including visit priorities, daily routines, previous visits, patient goals, and appointment preferences. The examples above show the conversation behind each completed field.
Can I add more details to the form?
Yes. Add visit details, preferences, or notes directly to the form. You can complete blank fields and adjust the wording before exporting.
Can I edit and export the intake PDF?
Yes. Edit the fields, make the form your own, and export the PDF for your clinic’s workflow.
Is the blank intake PDF free to download?
Yes. Download the one-page fillable PDF without a Vero account. It includes patient details, visit priorities, previous visits, preferences, goals, and additional notes. Type into the fields in a PDF reader or print it. You can also upload it to Vero Documents for auto-fill.
Start with their story. Finish with a clearer form.
Bring your next intake form into Vero.
No credit card required. Start with the free plan.