Hair Loss New Patient Information Sheet

Form Template

This is the Hair Loss New Patient Information Sheet.

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This is a comprehensive app for anyone treating new patients for hair loss. The patient inputs their personal information, health information, social history, family history and more. After putting in their information, the patient signs a release waiver at the end to release liability to the Company for any negative results. This app can also be customized to be as specific as you'd like, or take out any information that isn't relevant.

Features
  • Signature Capture
  • Conditional Fields
  • Submission Editing
  • Reference Data
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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