Intake and referral forms inside the document the client signs
Ask the intake questions in the same branded document as the plan and the signature, and let a completed form start your next step.
- 5/5 on G2
- 4.2 on Capterra
- Building QuoteCloud since 2013
On the Business plan, QuoteCloud's Forms block puts intake questions inside a document, next to text, fees and an eSignature block. The client or their family answers and signs in one place on any device, and the Form Submitted on Document trigger in Zapier can pass the answers to your practice or booking system.
Three views of the intake form inside a sample care agreement from a fictional provider, Kinfield Health: the blank questions as sent to Claire Avery, the same form answered (mornings from 8:00 am, walks with a frame indoors, key safe by the side door, Claire as the contact, a note about the family dog), and the document's activity, from intake form completed to signed, first week paid and the client record updated through Zapier.
From blank questions to a signed agreement
Rosalind's care agreement started as an intake form. Step through it as Claire saw it, then as Kinfield's care coordinator did.
The questions go out first
Leah sends Claire a short document from the intake template: a cover and the questions, in Kinfield's branding. Nothing about the plan is written yet.
Forms block: Business
Healthcare templates
In-home care agreement
Rosalind's recovery care at home
Your care plan after your hospital stay, set out visit by visit: personal care, a weekly physiotherapy visit and the fees, so you and Claire know what to expect before the first visit.
About you
FormForms block · sent for the client to complete
Claire answers from any device
Visit times, how Rosalind gets around at home, access, who else to talk to and a note about the dog. The answers come back in the same document, with no account to create.
Forms block: Business
Privacy & securityAbout you
FormForms block · completed before the plan was written
Completed by Claire Avery · Tue 27 Oct, 6:10 pm
The week follows the answers
Leah writes the plan from what Claire told her: personal care from 8 am on weekdays, as asked. The intake stays in the agreement, above the plan.
Price tables: Essentials and up
Care agreementsYour week
6 weeks · Mon 2 Nov to Sun 13 Dec 2026
| Service | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|
| Personal care8:00 am | Yes | Yes | Yes | ||||
| Physiotherapy10:30 am | Yes | ||||||
| Nurse visit9:00 am | Yes | ||||||
| Lunch prepared12:00 pm | Yes | Yes | Yes | Yes | Yes |
- Week 1
- Week 2
- Week 3
- Week 4
- Week 5
- Week 6
Visit times are confirmed by your care coordinator, Leah Whitford.
Answers, consent and signatures in one record
Rosalind and Claire tick the acknowledgements and each sign in their own signature block. The intake, the plan and both signatures share one audit trail and certificate.
eSignatures: every plan
Consent & signersConsent and acknowledgement
Locked wording · your team can't edit it
Please read and confirm before signing. Rosalind signs as the client; Claire signs as her representative.
- I have read this plan and cost estimate, and my questions have been answered.
- I understand these are estimated fees. A change to the plan is sent to me as a revised agreement to sign.
- I agree that Kinfield Health may share this plan with my referring practitioner.
- I understand I can ask to change or end the plan at any time.
2 of 2 signed
- Rosalind AveryClient SignedWed 28 Oct, 10:12 am
- Claire AveryDaughter and representative SignedWed 28 Oct, 10:15 am
Paid on signing$916.00Paid via Stripe
Certificate of authenticity and audit trail attached
A completed form can start your next step
The Form Submitted on Document trigger in Zapier can pass the answers on, for example to create the client in your practice or booking system, where that system has a Zapier connector.
Zapier: Essentials and up
Practice integrationsActivity
- Intake form completedClaire Avery, in the document
- Agreement openedClaire Avery, from the email link
- Meal preparation added+$90.00 a week
- Signed by Rosalind and ClaireCertificate of authenticity attached
- First week paid$916.00 via Stripe
- Client record updatedIn the practice system, through Zapier
Where each intake answer used to go
The questions are the provider's own. What changes is where the answers land and how often someone types them again.
How practices put the Forms block to work
A form inside a document, not a form on your website: it sits next to the text, fees and signature blocks of whatever you send.
An intake document before the plan
Send the questions on their own, then write the estimate or agreement from the answers. Forms block: Business.
Questions inside the agreement
Put the intake questions above the plan in the agreement itself, so the answers and signatures come back together.
Referral details
Send your own referral questions to the referring practitioner, in your branding, and keep their answers with the client's documents.
Saved as a template
Save the finished form as a template so every new client is asked the same questions. Templates: Essentials and up.
A QR code or button
Link a printed referral letter, poster or email to the document with a QR Code or Button block. Essentials and up.
Check who signs
Add an optional one-time passcode, sent by email, that the client enters before they can sign.
Privacy & security
Try the Forms block on the Business trial
14 days free, no credit card required. Send us your current intake form and we'll convert one template for you during the trial.
One record
The answers, the plan and the signatures in one document
No intake sheet to file, scan or match to the right agreement later. What the client told you sits above what they agreed to.
Set up your intake form in five steps
On the Business plan, in the template your coordinators already use.
Write your questions
List what your coordinators ask today: visit times, access, contacts and anything the team should know.
Add a Forms block
Open your intake or agreement template, drag in the Forms block and add each question as a field.
Place the signatures
Add an eSignature block for each signer, required or optional, beside your consent wording.
Save it as a template
Save it so every referral starts with the same questions, branding and wording.
Connect the next step
Optionally add a Zap on Form Submitted on Document to pass the answers to your practice or booking system.
Intake form questions, answered
Is the Forms block a website form builder?
No. The Forms block is a form inside a QuoteCloud document: the questions sit next to the text, fees and signature blocks of an estimate or agreement, and the client answers in the document you send them. If you want a form on your own website, your website or booking system can create a QuoteCloud document through the API, Zapier or Make.
Which plan includes intake forms?
The Forms block is on the Business plan (US$59 per user a month), with custom branding and the form builder. Saving forms as templates, QR code and button blocks, and Zapier, Make and the API are on Essentials and above. eSignatures are on every plan, and Business starts with a 14-day free trial with no credit card.
Can intake answers go to our practice management system?
Through Zapier, where your system has a Zapier connector. The Form Submitted on Document trigger can start a Zap that passes the answers on, for example to create or update a client record. QuoteCloud has no native practice management integration and copies nothing into a named system by itself.
Can the client answer the questions and sign in one go?
Yes. Put the Forms block and the eSignature blocks in the same document. The client, or their representative, answers and signs without leaving the document, on any device and without an account. The completed document carries a certificate of authenticity and an audit trail, and you can ask for a one-time passcode by email before signing.
Should clinical notes go in an intake form?
Ask only what your team needs to plan and agree the service, and keep clinical notes in your clinical system. QuoteCloud is not a clinical record system and does not state a health-record certification. It is hosted on Amazon Web Services with 256-bit encryption, and personal information is stored on servers in the USA. Check what you collect against your own obligations.
Can we ask every new client the same intake questions?
Yes. Save the document with its Forms block as a template, so every new referral starts with the same questions, branding and consent wording. On Business, content locking keeps chosen library blocks, such as your consent wording, from being edited by your team.
More for health providers
The agreements, consent and connections an intake form leads into.
-
In-home care & service agreementsWeekly or fortnightly services shown as repeating charges, a visit schedule, terms and an expiry date the family signs.Explore
-
Consent, acknowledgements & multiple signersConsent wording in a locked block, acknowledgements ticked and every signer (patient, guardian or representative) signing online.Explore
-
Practice management & accounting integrationsSigned agreements to your practice system through Zapier or the API, and accounting native on Business.Explore
- Treatment plans & cost estimatesThe plan, every fee line, what the estimate does not include and an expiry date, accepted and signed before treatment starts.
- Physio, OT & psychology programsSessions per week, the program schedule and a choice of program options, with the first fees paid on signing.
- Cosmetic & elective treatment quotesTreatment options side by side, a deposit to book, an expiry date and the patient's acknowledgements in one quote.
- Medical equipment & mobility quotesHire by the week or buy outright, delivery and set-up, product brochures as PDF pages, signed and paid online.
- Funded-plan service agreementsSupports, rates and a schedule set out for a participant and their nominee, with the agreement signed by both.
- Privacy, access & security for health providersWhat QuoteCloud confirms about hosting, encryption, signer verification and access control, and the questions to ask before you start.
- Healthcare templatesReal QuoteCloud templates for treatment plans, home care contracts, medical services and pharmacy agreements.
- QuoteCloud implementation for health providersFee schedules loaded, estimate and agreement templates converted, consent wording locked and the team trained.
- FAQAnswers to the questions clinics, allied health, care providers and equipment suppliers ask most.
Your next intake, answered and signed in one place
Free for 14 days. No credit card required.