Foyer — Patient Intake & Registration
A calm, HIPAA-secure patient intake & registration flow — guided wizard with insurance/ID upload, history, and e-signature.
verticomply.com/templates/patient-intake-form
Overview
Foyer is a warm, accessibility-first patient intake experience. A single-focus guided wizard captures demographics, contact and emergency details, insurance with insurance-card and photo-ID camera upload, medical history, medications and allergies, the reason for the visit, and consent with an on-screen e-signature — saved as you go. A front-desk review queue lets staff verify or flag each submission, backed by an immutable audit trail.
9
Features
8
Pages
~30m
Build time
4
Compliance
Features · 9
Guided intake wizard (8 steps, save-as-you-go)
Demographics & contact capture
Emergency contact
Insurance + insurance-card & photo-ID upload
Medical history, medications & allergies
Reason-for-visit & symptom onset
Consent + on-canvas e-signature
Returning-patient autofill
Front-desk review queue with audit trail
Admin / staff portal · 1 page
Ships with a built-in staff console alongside the patient-facing app. Your team gets a real-time operations view, verification controls, reminders, one-click actions, and a full audit trail — accessible at the standard /admin route, gated behind admin role-based access.
RBAC-gated
Audit trail
Multi-user
HIPAA-aware
Front desk
/admin
Intake review queue + detail (verify / flag)
Every page · 8
Public
Compliance · 4
HIPAA
BAA
WCAG 2.2 AA
GxP
Always included
Secure authentication & sessions
Role-based access control
Immutable audit trail
Seeded, realistic demo data
Responsive, WCAG 2.2 AA-minded UI
Editable branding, colours & copy
Clinical Practice & Facilities
A calm, HIPAA-secure patient intake & registration flow — guided wizard with insurance/ID upload, history, and e-signature.
8
Pages
30m
Build time
Compliance
Integrations