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.
A GP appointment runs ten to fifteen minutes. When a new patient arrives without a history, a third of that goes on questions the patient could have answered better at home — with their medication box in front of them and time to remember the name of their previous doctor. This template moves those questions out of the consultation and into an encrypted form the patient fills in beforehand.
The three answers that change what you prescribe
Most of an intake form is administrative. Three fields are not, and they are the reason pre-visit intake is a safety measure rather than a convenience:
| Answer | What it prevents |
|---|---|
| Current medications and dosages | Interactions — the anticoagulant that changes what can be prescribed today |
| Known allergies | An adverse reaction to a drug given before anyone asked |
| Chronic conditions | A prescription that is safe in isolation and unsafe against renal or hepatic impairment |
A clinician who knows about a penicillin allergy before writing the prescription is in a different position from one who learns it afterwards. The point of collecting this in advance is that the patient answers it accurately, not quickly.
What the form collects
- Patient contact and identification details
- Current GP details — so previous records can be requested
- 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 sensitive personal data under the Swiss nFADP. End-to-end encryption means submissions are readable only by your practice — not the platform, not email servers.
Why GP records are the most sensitive file a person has
A primary care record is unusual among personal data in that it spans a whole life and touches everything else in it. Diagnoses, medications and social history in a GP file can bear on employment, insurance and relationships decades after the consultation that produced them. That is the reason the legal treatment is strict rather than a formality: under GDPR Article 9 and the nFADP, this data needs a lawful basis, security proportionate to its sensitivity, and a retention policy that someone has actually decided.
End-to-end encryption is the part of that you can settle architecturally rather than procedurally. Each submission is encrypted on the patient's device before it is sent, and your practice holds the only Vault key that opens it — so the intake record is not readable by us, by anyone intercepting it, or by anyone who reaches the storage behind it. Retention remains your decision; encryption removes the failure modes that do not depend on a decision.
Where paper intake actually goes wrong
- Medication lists written from memory in a waiting room, without the box or the repeat slip to check against
- Allergies mentioned aloud at reception and never written into a structured field
- Completed sheets emailed as PDF attachments, which is health data leaving the practice unprotected
- A drawer of intake forms with no retention date, because nothing ever triggered a decision to delete them
Getting it completed before the visit
Use this template
Copy it into your dashboard — medication, allergy and consent questions are already structured.
Adjust it to your specialty
Add specialty-specific history questions, or remove sections that do not apply to your practice.
Send it with the appointment confirmation
Patients complete it at home, where they can check their medication list rather than recall it.
Questions practices ask
What if the patient does not fill it in beforehand?
Then you are where you are today, and no worse. The realistic pattern is a tablet at reception for the ones who arrive without having completed it — same form, same encrypted record, just answered later and usually less accurately.
Is the intake data GDPR compliant?
The template is built for it: explicit consent is captured, the field set is deliberately minimal, and submissions are end-to-end encrypted so only your practice can read them. Retention stays your responsibility — the form does not delete anything on its own.
How is the medical data protected?
Each answer is encrypted in the patient's browser before it leaves the device. Your practice holds the only key that opens it — we do not have one, so we could not read an intake form if we were asked to.
See our use case for healthcare and primary care practices, our guide to collecting health data in forms, and the medical records release template for requesting a new patient's previous file.