Patient intake form QR code for waiting rooms

New patients fill in their details on their own phone while they wait, and the front desk gets typed answers.

A patient intake form QR code opens your new patient form on the patient's phone. Use the form of your practice software or a form tool that handles health data securely, paste its link above and print the code at reception, in the waiting room and in the appointment confirmation.

Type of code

All QR code types

Contact

Social

Wi-Fi and tools

Payments

Pages we host for you

Menus, link lists, event pages and more live on a page we host. Start them in the app with a free 14-day trial.

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Content

For example yourbrand.com/menu

A PDF code points to a file we host, so it is always an editable code.

Your PDF

or drop it here

Up to 10 MB on the trial, 25 MB on paid plans and passes. Your PDF opens on a page you can update any time, under the same code.

Fixed or editable?

Will this be printed, and might the link ever change?

Free · Works as long as your link works · Set once

Change the link any time, even after printing · See every scan · 14 days free, then from $9/month or $12 once

Design

A clean design that prints well is ready. Customise the look whenever you like.

Templates

Start from a template

Style

Dot style
Corner frame
Corner dot
Shape

Colour

Code colour

For example #1b2a4a or rgb(27, 42, 74)

Background

For example #1b2a4a or rgb(27, 42, 74)

Frame

Frame

Up to 40 characters. Left empty, the frame uses the first suggestion, shown in grey until you type.

Icon beside the text

Icons show beside the text on the frames from Banner on.

Download

Fill in your form here
Example code. Type your content to make your own.

Editable: works while your plan or pass is active

How big should it be?

File format

PNG is free to download. A free account adds SVG, PDF and print files.

Sticker sheet (PDF)

Fill a printable page with this code on label stock.

Continue to create an editable code

Create a free account to make this code editable. Your content and design stay here while you sign up.

How long fixed and editable codes keep working

Done while waiting

A new patient scans the reception poster and completes the form before their name is called.

New patient form: About 4 minutes, saved as you go Start form

How to move intake forms to the phone

  1. Use a secure form

    Your practice software or a form service with health data protection gives you the form link.

  2. Make the code

    Paste the link above, with a frame line such as "Fill in your form here".

  3. Place it twice

    At reception for walk-ins and in the confirmation message, so patients can fill it in at home.

  4. Keep paper ready

    A clipboard for patients who prefer paper keeps everyone included.

Worked example: a dental practice

The sign
A reception poster reads "New here? Fill in your form here" above a 6 cm code.
The message
The booking confirmation carries the same code, and half of new patients arrive with the form done.
The desk
Staff stop typing handwritten forms into the system and greet patients instead.

Fixed or editable for intake forms?

Forms patients finish

Questions and answers

Before you print

Is it free?
Fixed codes are free: make as many as you like, download a PNG with no sign-up, and get every other format and print files with a free account. Editable codes come with a plan, a pass, Keep-alive or the 14-day trial.
Can I change the link after printing?
Yes, with an editable code. It holds a short link you control, so you can point the printed code somewhere new any time, and the next scan opens the new page. A fixed code keeps the link it was made with.
Can I use my own domain?
Yes. A custom domain is included on passes, from Starter, and during the trial. Starter covers one subdomain, for example go.yourbrand.com, and apex domains start on Pro.
What happens if I stop paying?
Editable codes work to the end of your paid period, and after a failed payment every code keeps working for 14 days. Turn codes back on within 12 months. Fixed codes keep working as long as their links do.
Which form tool should a practice use?

Your practice software or a form service built for health data, with secure storage and access control. The code only opens the form link.

Does the QR code store patient data?

No. The code holds only the form link. Answers go straight into the form tool you chose.

Can patients fill in the form at home?

Yes. Put the code or its link in the appointment confirmation, so new patients arrive with the form done.

What about patients without a smartphone?

Keep paper forms and a clipboard at reception. The code is the quick way; paper works just as well.

How big should the code be on a waiting room poster?

About 5 to 6 cm, so patients can scan from their seat a metre or two away.

Can I use different forms for new and returning patients?

Yes. Give each form its own code with a clear label, or link a short page where patients choose.

Can the form ask for a signature?

Many secure form tools collect a signature on the phone screen. Check that yours does before you replace a paper form that needs one.

How often should I review the intake form?

Read it once a year, or when your services change. With an editable code you can switch to the new version without changing a single poster or message.

Forms done before the call

Paste your intake form link and print the reception poster today.