Shopko Support

How to Create a Patient Intake Form

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This tutorial will demonstrate how to configure your Vision(X) site for use with the CLX ordering platform.

Vision(X) Settings

In the Settings section of your Vision(X) site, select the Intake Form subtab. The General tab displays your site's intake forms, with

Configuration

The Configuration menu will appear, with options presented that will govern who receives this intake form based on selections for Appointment Type, age range, etc. Enter information as applicable, then click "Continue":

Customization

The intake form Customization menu will appear. The form is divided into informational sub-sections, which can be selected from the list on the left-hand side of your screen. Alternatively, work top to bottom to enter information in all required fields (marked by blue asterisk), or click "+Add New Question" as applicable. then scroll down to continue:

Continue to the next subsection of the form. To edit or hide an item from the intake form, click its line item to access customization options:

Continue to the next subsection of the form. To change the order in which line items appear, hover your cursor over the right-hand side of the line, then grab to drag and drop when the hand icon appears:

Continue to the next subsection of the form. To change the title of any subsection, click the pencil icon in the section header:

Continue to the final subsection of the intake form. To preview what the compiled form will look like to the patient, click "Preview":

The intake form preview will display. Here you can proceed through each successive screen to review the entire form:

When all intake form subsections are complete, click "Continue":

Attach Document

If you have additional documents that you want to appear attached to the intake form, select them from the search list provided. When finished, click "Save":

Success!

You will receive a confirmation that the new form has been saved:

The new form is now available for use, and will appear displayed in the Settings > Intake form subtab: