Get in line for the first calls.
The plan is simple: an AI agent walks you through everything by phone — no typing, no forms — and you see your completed profile before you ever pay anything.
We're not open to the public yet. Tell us how to reach you and we'll get in touch when we start booking calls.
Early access: we're not open to the public yet. Picking a time tells us when suits you, it does not schedule a call.
Fill it out once. Never again.
Most clinics ask for the same information in a slightly different order. We keep one accurate profile and map it to whatever form is in front of you.
The AI agent calls you
At the day and time you choose, an AI voice agent walks you through demographics, medications, allergies, family and medical history, insurance, and emergency contacts — at your pace, in plain conversation.
Your profile gets built
Everything you said is organized into one accurate, always-current record. Upload the clinic's form, pick from our library of common ones, or just tell us where you're going — every field gets filled and checked for gaps.
Sign and go
Print it, show it on your phone, or send it to the office ahead of time. When something changes — a new prescription, a new address — update it once and every future form is current.
Real detail, not vague "health info, organized"
Here's what we actually capture, because this is what clinics actually ask for.
Demographics & contacts
Legal name, DOB, address, preferred pharmacy, primary care provider, and emergency contacts with relationship and phone number.
Medications & allergies
Drug name, dose, frequency, and prescriber for every active medication — plus allergies with the specific reaction, not just the substance.
History & consents
Surgical history with approximate dates, family history by condition and relation, and the consent-to-treat and insurance-assignment language most intake forms require.
For anyone who's tired of the clipboard
If you've ever guessed at a dosage in a waiting room or forgotten the year of a surgery, this is for you.
Every form, once
Every pediatrician, dentist, camp, and school wants the same forms. Keep each child's profile ready.
Managed with permission
Manage a parent's or client's file with their permission, and hand it off cleanly when someone else takes over.
Accurate every time
Long medication lists and specialist histories are exactly what gets mis-typed on paper. Get them right every time.
Watch a real call, start to finish
Here's what actually happens when you book: a conversation, not another form to type into.
Your health information belongs to you. We just keep it safe.
We designed IntakeFormHealth around the HIPAA Privacy and Security Rules from day one, so that clinics, caregivers, and families can trust what we hand them.
Have questions about how we handle protected health information? Read our privacy practices or see where our HIPAA commitments actually stand.
Simple pricing
Start free with a single profile. Upgrade when you're managing more than one person or want us to handle the sending.
Free
- One health profile
- Fill any uploaded form
- Print or show on your phone
- Medication and allergy list
Family
- Everything in Personal
- Profiles for kids, parents, and yourself
- Invite caregivers with limited access
- Send forms to the clinic ahead of time
- Reminders to update after each visit
Custom
- Unlimited client profiles
- Signed Business Associate Agreement
- Staff roles and permissions
- Branded forms and direct-to-clinic delivery
- Onboarding for your team
Already had your free call and built a profile? Choose a plan above and it's yours to keep and share.