Electronic Forms Available In Healthie

Healthie provisions you with a library of templated forms and charting notes, as well as the ability to build your own forms. 

Healthie's templated default intake and charting forms can be found in your Forms Library. Depending on the specialty that you indicated when signing up for Healthie, you may also see specialty-specific forms for your use (ie. Nutrition, Behavioral Health, Coaching, and more).

In addition, if you are currently enrolled, or a graduate of a coaching or certificate program, Healthie can share pre-built forms provisioned by our affiliates (see Coaching & Certificate Program Forms). 

We recommend consulting with an attorney and/or insurance companies that you work with, to confirm that intake forms and charting templates, as well as disclaimers that are available through the platform, are acceptable for your use.

Standard Forms Not Visible in the Forms Library 

Some of the available forms will not appear in your Form's Library, which indicates that they are a fixed-form and cannot be edited. These forms can be sent to your patients by adding them to an intake flow, which will automatically send to patients for electronic completion.

Forms that are automatically added to your account, but not visible in the forms library include: 

• Billing Info form (to collect a credit card on file) 
• Insurance information form (to collect insurance details & a copy of the insurance card), and the 
• Photo ID form (to collect a copy of the client's ID such as a license). 
• Incident Report form

To view forms that do not appear in your Forms, we suggest that you add them to an intake flow and "Preview" the flow. This will walk you through your client's experience with your electronic paperwork. 

Billing info

Request a client's card information be securely kept on file. This is useful to charge no-show fees/cancellation fees, as well as purchase packages for clients on behalf of them. 

This form is not visible in the Forms Library, and cannot be edited directly.  

More information: Billing Info Form

Insurance info

Request that a client enter their insurance information - you can use this for an eligibility check, and information will auto-fill into any CMS-1500 forms you'd like to generate in the future.

This form is not visible in the Forms Library, and cannot be edited directly.  

More information on insurance information here.

Photo ID 

Collect a copy of your client's identification, such as a valid driver's license. 

This form is not visible in the Forms Library, and cannot be edited directly.  

Learn more here. 

Client Profile Picture 

Have a client add a profile picture, which they can upload directly from their computer. Learn more about picture sizing requirements and supported file types here. 

This form is not visible in the Forms Library, and cannot be edited directly.  

Incident Report 

Need to document a reported client incident? Leverage this form to collect client information, data of incident, and incident details.

Practice Policy Forms & Waivers

• HIPAA Privacy Policy (English & Spanish)
• Financial Agreement
• Cancellation Policy
• Client Testimonial Waiver & Testimonial Release
• Physician Authorization of Release
• Release of Information
• Medical Record Release Form
• Consent to Treat
• Consent to Treat Minor (child)
• Covid-19 Screening Form
• Advanced Beneficiary Notice (ABN) Form
• Waiver of Liability
• Client Exit Survey

Assessment & Charting Forms 

Healthie hosts several assessment and charting note templates that can be customized. Use the charting forms as-is, or adjust them to fit your practice needs. Doing so can help reduce time on charting, and improve your workflows. Healthie chart notes can also be shared with clients, other team members, and external care-team members (all in a HIPAA-compliant manner). 

• Healthie SMART Form (English & Spanish)
• New Patient Assessment
• New Patient Medical History Questionnaire
• Patient Intake
• Health History
• Patient Discharge
• SOAP Note
• ADIME
• PES Statement
• Treatment Plan

Telehealth Forms

• Telehealth Informed Consent
• Group Telehealth Informed Consent
• Informed Consent for E-mail Communication

Nutrition Specialty Forms

• Consent for Nutritional Services
• Nutrition Assessment (for Doctor)
• Nutritional Supplement Informed Consent
• Eating Disorder (ED) Assessment Form
• Emotional Eater Questionnaire (EEQ)
• PES Statement
• Supplement Schedule Note

Health Coach Specialty Forms 

• Liability Waiver for Health Coaching
• Pre-Coaching Questionnaire
• Health Coaching Initial Assessment

Behavioral & Mental Health Specialty Forms

Leverage these behavioral health specific forms to build treatment programs and set functional goals individualized to their patients current condition. Learn more here. 

• Patient Health Questionnaire 9 (PHQ-9)
• General Anxiety Disorder 7 (GAD-7)
• 40+ charting templates and industry-standard assessments

Physical Therapy Specialty Forms 

A library of forms specifically designed for physical therapy practice can be access here. 

Chiropractor Specialty Forms

A library of forms specifically designed for chiropractic practice is available within Healthie. These forms include

• Chiropractor Informed Consent Form
• Chiropractor Assessment
• Terms of Acceptance & Informed Consent
• Note of Privacy
• Financial Policy
• Standard Arbitration Agreement

Coaching & Certificate Program Forms

Healthie has partnerships with many coaching academies, graduate schools, and accreditation services, whose graduates use the platform to run their businesses and build relationships with clients. As part of these affiliations, Healthie makes it easy for you to access recommended forms from these coaching programs, which allows clients to fill out these forms online.

Review these available forms here.

Additional Forms

In our library we also have a variety of ad-hoc forms used across specialties, including:

• Informed Consent for IV Hydration
• Informed Consent for Ketamine Treatment