New Patient Intake
An encrypted new patient intake form for general practices — medical history, medications, allergies, emergency contact and consent, all secured end-to-end.
About this template
This template provides general practices and primary care clinics with a complete new patient intake form. Patients fill it in before their first appointment, giving the clinician a structured medical history that is ready to review before the consultation begins. All data is encrypted end-to-end.
What it collects
- Patient contact and identification details
- Current GP details
- Reason for today's visit
- Current medical conditions
- Medications and dosages
- Known allergies
- Emergency contact
- Consent to treatment and data processing
Encrypted by default
Medical history is special-category personal data under GDPR Article 9 and the Swiss nFADP. End-to-end encryption means submissions are readable only by your practice — not the platform, not email servers.
How to use it
Use this template
Click 'Use template' to create a copy in your dashboard.
Customise to your specialty
Add specialty-specific history questions or remove sections not relevant to your practice.
Share before the first visit
Send the link when confirming the appointment so patients complete it at home.
Why general practices need a digital new patient intake form
A GP appointment typically runs 10–15 minutes. When a new patient arrives without a structured history, the clinician spends a significant portion of that window asking basic intake questions — medications, allergies, current conditions — rather than addressing the presenting problem. A digital intake form shifts this work to before the visit, where the patient can answer at their own pace, consult their medication list, and look up the name of their previous doctor.
Pre-visit intake also improves safety. A clinician who knows about a patient's penicillin allergy or current anticoagulant therapy before prescribing is less likely to cause an adverse event than one who learns these facts in the moment. Structured digital intake captures this information reliably and makes it immediately available at the point of care.
What a new patient intake form for general practice should include
A complete primary care intake form should cover the full clinical picture:
- Identity and contact — name, date of birth, phone, email
- Referring or previous GP — so records can be requested
- Chief complaint — the primary reason for registering
- Medical history — chronic conditions, past diagnoses
- Current medications — names, dosages, frequency
- Known drug, food and environmental allergies
- Emergency contact — name and relationship
- Consent — explicit agreement to treatment and data use
Patient data in primary care — GDPR and Swiss nFADP obligations
GP records are among the most sensitive personal data in existence — they span a patient's lifetime and include diagnoses, medications, and social history that could affect employment, insurance and personal relationships. Under GDPR Article 9 and the Swiss nFADP, this data requires explicit consent to process, appropriate technical security, and a clear retention policy. End-to-end encryption is the strongest technical safeguard available: data is encrypted before leaving the patient's device, and only the practice holds the decryption key.
Paper intake vs encrypted digital intake
| Paper intake | Encrypted digital intake | |
|---|---|---|
| Availability before consult | Filled in waiting room | Completed at home in advance |
| Allergy/medication accuracy | From memory, often incomplete | Patient checks their records at home |
| Compliance | Hard to prove consent, no encryption | Consent captured, encrypted at source |
| Workflow | Staff re-type into system | Structured data ready to use |
Common mistakes to avoid
- Not asking about current medications — this is the most common safety-critical omission.
- Collecting allergy information verbally without documenting it in a structured format.
- Using unencrypted email or PDF attachments for medical intake.
- No clear retention policy — patient records must be kept for the legally required period.
Frequently asked questions
Can patients complete the form on their phone before the appointment?
Yes. The form works on any device. Patients can complete it at home, which gives them time to consult their medication list and look up medical history details.
Is the intake data GDPR compliant?
This template is designed for compliance: it captures explicit consent, collects the minimum necessary data, and uses end-to-end encryption so only your practice can access submissions. You are responsible for your retention policy.
How is the medical data protected?
Every answer is encrypted in the patient's browser before it leaves their device. Only your practice holds the decryption key — not Schweizerform, not email servers, not any third party.
See our use case for healthcare and primary care practices, our guide to encrypted patient data collection, and our comparison of Schweizerform with Google Forms for medical intake.