Patient intake

Start registration with a calmer, mobile-friendly patient intake flow.

This page captures the same core Epic 3 information in progressive steps so patients and clinic staff do not have to fight a single overwhelming form.

Patient self registration

Basic details come first, then contacts, medical background, and preferences. Draft saving is built in so the flow can continue without losing work.

Patient self registration

Patient intake

A simpler patient-side registration experience with progressive sections, clear review states, and local draft saving.

Step 1 / 4

First name

Last name

Middle name

Preferred name

Date of birth

Gender

Mobile number

Primary branch

Registration branch

Profile notes