Urgent Care Encounter Form

Form Template

The Urgent Care Encounter Form mobile app helps nurse practitioners and other health care providers collect information about patients in urgent care centers or other walk-in care clinics.

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This app can be downloaded to an iPhone, iPad, and Android device.

This online check-in app collects basic patient information, such as height, weight and vitals, past medical history and current medications, orders, and treatments.

This app is also beneficial for any primary care physician who receives medical information about patients who visited a walk-in clinic due to work-related injuries and may need to fill out a workers' compensation form.

All information provided during any emergency care is securely stored in the GoCanvas Cloud. The info can be printed or emailed as PDF to the patient or as proof of medical care.

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  • iPhone
  • iPad
  • Android
  • Windows
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  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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“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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