New Medical Patient Information - Motorola Solutions

Form Template

This form allows doctors and hospitals to collect information about new patients.

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It collects basic patient information, patient details like height, weight and blood type, past medical conditions and drugs taken, health insurance information and a signature for assignment and release of the medical information. This app works on a variety of Motorola Solutions devices, including the ES400 and ET1.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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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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