Patient Intake QR Code

Patient Intake Form

Scan this QR code to access the patient sign-in form

Instructions for Patients

  1. 1. Open your phone's camera app
  2. 2. Point it at the QR code above
  3. 3. Tap the notification to open the form
  4. 4. Fill out all required information
  5. 5. Submit the form

Display this QR code in your waiting area for easy patient check-in