Templates Healthcare

Healthcare

Patient Intake Form

Demographics, insurance, and chief complaint — pre-wired with PHI handling.

What's inside

  • Patients entity — name, date of birth, intake status, clinical notes
  • Patient Intake Tracker app — internal-only utility for staff to review and update intakes
  • Patient Triage workflow — fires on each new record; AI summarizes clinical notes and moves the patient to *In Review*
  • 3 sample patient records so the app is populated immediately

Patient Intake Form

Spin up an internal-facing intake tracker in under a minute. Each new patient record kicks off an AI summarization of the clinical notes and advances the patient’s status, so the front-desk handoff to clinical review is automatic.

How it works

  1. A staff member submits a new intake via the Patient Intake Tracker app.
  2. The record is created in the Patients entity with status pending.
  3. The Patient Triage workflow fires automatically:
    • Reads the clinical notes from the new record.
    • Uses Claude to draft a concise clinical summary.
    • Updates the record’s status to in_review.
  4. Clinical staff see the updated record at the top of the queue, ready to act on.

What you can extend

  • Add insurance, demographics, or referral source fields by editing the entity schema.
  • Route urgent intakes to a Slack channel or pager — add a second workflow step.
  • Replace the internal app with a public-facing intake form by switching the app’s audience to Public.
  • Hook the workflow output into your scheduling system once you’re ready.

Data handling

Patient intake data flows through HASP’s policy-aware AI gateway — your org’s data-handling configuration is enforced automatically at every inference call. You can build and test the template on Free Evaluation; the underlying policy enforcement is the same posture every paid org gets.