Consent and Intake Forms for Chiropractic Clinics
Intake questions and a signed consent are collected before the first adjustment. Both are saved against the patient’s record with the date, so the doctor can see them at the next visit.
Two forms, one record
At the front desk
Reception hands over the tablet or scans the signed paper. A plain marker shows when consent is missing. A doctor who opens a first visit without it sees the gap at once.
Repeat consent
Fresh consent may be needed. A change in treatment or a long gap between visits can call for it. The clinic sets the rule, and the marker appears when that rule is met.
What the clinic supplies
GullySystem does not write consent text. The clinic provides its own wording, reviewed by its doctor or advisor. The form and the stored signature are ours to set up. What the text must say is not for us to state.
Frequently asked questions
Can the form be filled on a phone?
Yes. A link can be sent for the patient to complete before arriving, where the clinic switches that on.
Is the signature stored as an image?
Yes. The signature and the time are kept with the form, and the printed copy shows both.
Can forms be in Kannada or Hindi?
Yes. Which languages are shown is set during scoping, with wording supplied by the clinic.
Can a form be revised later?
Yes. A new version applies from the date it is published. Forms signed under the earlier wording keep that wording.
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