Forms & eSignยท Platform

Intake without the clipboard

Import the forms you use today, send them before visits, and get them back signed on the patient's phone. Orpheus reads every one, and the signed PDF files to the chart.

Build our intake form from the PDF we already use?Ultradoc does that.

app.ultradoc.net/settings/forms
Forms/Untitled formDraft
Publish

Untitled form

Add a description

Add your first question

Pick what you want to ask. Patients answer the questions in the order you arrange them here.

AssistantSettings
Form assistant

Build this form by asking

Attach a paper form or a document to import it, or describe the questions you need.

Import this form for meCheck this form for problemsMake the wording clearer for patients
Ask for a change to this formโ€ฆ

A packet's week

Maya Okafor's first visit at Northgate Family Medicine is Thursday at 9:00 AM. Follow her intake packet through the week before it, every step timed, tracked, and visible to your whole team.

Oct15

New patient visit ยท Thu, 9:00 AM

Maya Okafor ยท Dr. Anika Rao ยท Northgate Family Medicine

  1. Thu, Oct 8 ยท 9:00 AM7 days out

    Sent before the visit, on its own

    A rule for each appointment type sends the right forms days ahead. Staff can send a packet from any chart too, right away or scheduled up to 90 days out, with an optional due date.

    Forms before the visit: New patient visit

    Sent 7 days before the visit ยท 3 forms

    New patient packet

    Fill in order
    1. 1New patient intake
    2. 2Medical history
    3. 3Notice of privacy practices

    Sent automatically to Maya Okafor

  2. Northgate Family Medicinenow

    You have 3 forms from Northgate Family Medicine to fill out. Open Forms here in the app to get started.

  3. Sat, Oct 10 to Mon, Oct 125 to 3 days out

    Followed up until it's done

    Reminders go to the app, fall back to a text, and can include an automated call, on the schedule your practice sets. The moment the last form comes back, the rest are cancelled.

    New patient packet

    Maya Okafor ยท Before the visit on Thu, Oct 15

    Completed

    The patient finished every form. Reminders still to come were cancelled.

    Not on the app? The same reminder goes by text:

    Northgate Family Medicine: Before your visit on Thu, Oct 15, 9:00 AM, complete a form in Ultradoc: ultradoc.net/app

  4. Sat, Oct 10 ยท 9:00 AMReminder by app message, delivered

  5. Mon, Oct 12 ยท 9:00 AMReminder by automated call, no answer

  6. Mon, Oct 12 ยท 7:41 PM3 days out

    Filled out and signed on the phone

    Patients photograph their insurance card and confirm what Ultradoc read from it, then sign with a finger or by typing their name. A checklist shows what's left before Send.

    On Maya's phone ยท Form 1 of 3, New patient intake

    Insurance card

    Check these details and fix anything we got wrong.

    Insurance company

    Harborline Health

    Member ID

    HLX440299

    Group number

    77421

    Signature

    DrawType
    Maya Okafor's signature

    Signed by Maya Okafor

    Send form
  7. Mon, Oct 12 ยท 7:42 PMA minute later

    Read by Orpheus, ranked for review

    Orpheus reads every form that comes back, writes a summary, and ranks its urgency against rules you write in plain language. Needs review puts the most urgent first.

    FormsSend forms
    Needs review5Waiting on patients
    1. Daniel Kowalski

      Pre-op questionnaire

      Urgent. Reports chest pressure on stairs this week. Knee replacement is scheduled for Oct 28.

      18 min ago
    2. Priya Raman

      Mood check-in

      High. Sleep and appetite worse since the last visit. Asks for a sooner appointment.

      1 hr ago
    3. Tom Becker

      Prescription refill

      Elevated. Out of metformin since Sunday. Asks for a 90-day supply at his usual pharmacy.

      2 hr ago
    4. Leo Martinez

      Sports physical

      Routine. Parent reports no concerns. Asthma inhaler already on file.

      3 hr ago
    5. Maya Okafor

      New patient intake

      Routine. New patient. Allergic to penicillin (hives); takes lisinopril daily. Insurance card attached.

      just now
    Most urgent first, then oldest first
  8. Tue, Oct 13 ยท 10:20 AM2 days out

    Filed to the chart as a signed PDF

    Mark it reviewed and the PDF files itself into the patient's chart in your EHR, under the document type you choose, with a review task for a provider when you want one. Need it there sooner? File it before review.

    New patient intake

    ReviewedVersion 1

    EHR filing

    Filed

    Filed for review by Dr. Anika Rao on Oct 13, 2026, 10:20 AM.

    Document typePatient forms
  9. Wed, Oct 14 ยท 9:00 AMReminder by app message, cancelled before it went out

  10. Thu, Oct 15 ยท 9:00 AMThe visit. Nothing left to fill out at the front desk.

The builder

Fifteen ways to ask

From a short answer to a photographed insurance card, every question gets the control it needs on the patient's phone. Pick one to see both sides.

Add question

Type an answer

Pick an answer

Send files

Photograph a card

Agree and sign

On the builder's canvas
4.

Insurance card*

Photograph the front and back.

FrontBack
In the patient's app
Insurance card
FrontBack

Photograph the front and back.

Follow-ups only when they matter

Show a question only after an answer above it calls for it, with as many conditions as you need. Patients never wade through questions that don't apply to them.

  • A signature signs everything above it, and the builder says exactly what each one covers before you publish.
  • Titles, descriptions, formatted text, and images sit between questions for consents and instructions.
The rule, set on the question

How many cigarettes a day?

Short answer
Show only whenโ€ฆ

Show this question whenallof these are true:

Do you smoke?isYes
Try it as the patient
Do you smoke?
How many cigarettes a day?
Any allergies?
YesNo

eSign

Every signature carries its evidence

Who signed, for whom, how, and from where, with a fingerprint of exactly what they saw. If the record changes after signing, Ultradoc says so.

Parent signature

Cancel

Signing for Mateo Delgado as their parent

Signature of Rosa Delgado

By signing, I electronically sign "Consent to treat a minor" as shown above on behalf of Mateo Delgado, as their parent. My electronic signature is the legal equivalent of my handwritten signature.

Try Draw or Type, then Sign.

Consent to treat a minor

Cedar Pediatrics ยท Mateo Delgado ยท DOB 06/02/2019

Download PDF
Parent signature
Signature of Rosa Delgado

Signed by Rosa Delgado, parent of Mateo Delgado

Oct 9, 2026, 7:52 AMVerified

By signing, I electronically sign "Consent to treat a minor" as shown above on behalf of Mateo Delgado, as their parent. My electronic signature is the legal equivalent of my handwritten signature.

I am Mateo Delgado's parent and have the legal authority to sign for them.

Method
Drawn on the signer's device
Signer
Rosa Delgado
Signer user ID
8c41f0e2b7d9
Capacity
Parent of Mateo Delgado
Signed for
Mateo Delgado
Account email
rosa.delgado@example.com (verified)
Account phone
(555) 014-7781
Sign-in
Password
Second sign-in factor
Held by the account when it signed
Session ID
3fa1c9e07b52
Session started
Oct 9, 2026, 7:31 AM
Sign-in network
198.51.100.24
Signing IP address
198.51.100.24
User agent
Ultradoc/412 (iOS 26.0)
Device
As reported by the signer's device:
Platform
iOS
OS version
26.0
App version
4.12.0 (build 412)
Update ID
None: the app's built-in bundle
Device model
iPhone 16
Records disclosure
Version 1, accepted Sep 2, 2026, 6:10 PM
Statement version
1
Statement
By signing, I electronically sign "Consent to treat a minor" as shown above on behalf of Mateo Delgado, as their parent. My electronic signature is the legal equivalent of my handwritten signature.
Attestation
I am Mateo Delgado's parent and have the legal authority to sign for them.
Signs
Consent to treat a minor
Signed at
Oct 9, 2026, 7:52 AM
Signed content SHA-256
6f1d0c9a4be27e835c1f90d24a7b6e1308c5f2d9e4a17b03c86d5e2f91a4c7b0
Signed content format
1
Record check
Intact: the signed content rebuilt from the practice's record hashes to the SHA-256 above

Consent comes first

Before their first signature with your practice, patients agree to sign electronically and can ask for paper instead. If they withdraw, staff record it on the chart.

Parents and guardians

Only a minor's parent or legal guardian can sign for them, and they affirm that authority before they sign. Adults sign their own forms.

Change an answer, sign again

If an answer a signature covers changes, or the practice updates the form, the signature clears and the patient is asked to sign again.

A copy for everyone

Every completed form becomes a PDF copy, and a signed one carries its signing certificate and event history. Patients open their copy in the app, and staff download it.

Insurance cards

The card, read for you

Patients photograph the front and back, and Ultradoc reads the plan, member, and pharmacy details for them to check. The front desk adds it to the chart in one step.

Insurance card

Photograph the front and back.

FrontBack
Take photoChoose photo

Add this insurance card to the chart

This chart already holds Primary coverage. Choose whether the card updates it or replaces it.

Chart

Maya Okafor ยท DOB 03/14/1988

File as

Primary

Update this coverage

For the same plan. The card's values replace what the row has for them, and everything else on it stays.

Replace it with this card

For a new plan. The row keeps only what the card carries, and everything else on it is cleared.

After addingOn the chart now
PlanHarborline Health Choice PPOHarborline Health Choice PPO
Group number7742161180
Subscriber nameMaya OkaforMaya Okafor
Subscriber numberHLX440299HLX301457
CancelAdd to chart

Follow-up

Answers that become tasks

Set a form to create a task only when the answers call for one. The assistant writes it from what the patient said, and it lands with the right roles.

Prescription refill

Settings

Follow-up task

Whether a response creates a task for your team, and where it goes.

Create a task whenanyof these are true:

How soon do you need it?is any of2 answers

Category

Refill requests

Default priority

Normal

Assign to roles (optional)

NurseMedical assistantFront desk

Write the task with AI

The assistant reads the answers and writes the task's title and summary. Off, the task lists the answers as they were sent.

AI instructions (optional)

Mention our 48-hour refill turnaround. Name the pharmacy.

Let AI raise priority

It can always lower priority when a patient says there's no rush. Raising it is off unless you turn it on.

Answer as the patient

How soon do you need it?

The answers matched this form's rule.

Refill metformin 500 mg: patient is out

Tom Becker ran out on Sunday. 90-day supply to Elm Street Pharmacy, Riverside, within our 48-hour refill turnaround.

HighRefill requestsNNurse, Medical assistant

From Prescription refill ยท Tom Becker ยท DOB 02/09/1971

The details, covered

The small things that decide whether paperwork gets done before the visit or at the front desk.

Drafts and versions

Edits save to a draft as you go. Patients keep answering the published version until you publish, and every response stays tied to the version it answered.

An assistant for every form

Ask it to check a form for problems before you publish, or to make the wording clearer for patients. Admins share the conversation, and its changes can be undone.

Packets, in order

Save the forms you send together as a packet. Turn on Fill in order and the patient fills them one after another, in your order.

Forms after a visit

Rules per appointment type send forms a set time after checkout or the end of the visit, followed up by the same reminders.

Nothing asked twice

A visit's rule can leave out forms the patient finished recently, anywhere from one month to three years.

Ready at the front desk

The arrivals board flags visits that still owe forms. Staff can record them as completed elsewhere, or skip them with a reason, right at check-in.

Waiting on patients

See every form still out, its reminders so far, and what goes out next. Remind now, send again, put it on hold, or record it as done on paper.

Reminders that stay private

Texts and notifications say a form is waiting, never which one, because a form's title can name a condition.

Forms patients start

List a form in the app for patients to fill whenever they like. Prescription refill and Insurance and ID update come ready to publish.

Visit-day reminder, on screen

From 15 minutes before a visit, forms still owed for it open over the patient's home screen, so they're done before the front desk asks.

Stop and finish later

A half-finished form saves as a draft on the patient's phone, encrypted, and opens again where they left off.

Reports on your forms

See submissions and follow-up tasks by form, what's awaiting review, and how many forms sent before visits were completed.

Where it connects

Forms take their cues from the schedule and hand what comes back to the chart, the task list, and your EHR.

Built for every kind of practice

The same forms engine, set up around how each practice runs its visits.

Family medicine

New patients, ready at check-in

Northgate Family Medicine sends its new patient packet a week before every new patient visit, in order: intake, history, privacy notice. Forms finished in the last year are left out.

Orthopedics

A pre-op packet the surgeon trusts

Summit Orthopedics sends a pre-op questionnaire and surgical consent a week out. A severity rule ranks chest pain as urgent, and the signed consent files to the chart for the surgeon's review.

Pediatrics

Parents sign for their kids

Cedar Pediatrics sends its consent to treat to the parent's app. The parent affirms they're the child's parent or legal guardian, signs, and the certificate records who signed for whom.

Behavioral health

Check-ins between sessions

Lakeside Behavioral Health sends a mood check-in the day before each follow-up. A plain-language severity rule tells Orpheus to rank any mention of self-harm as urgent, so it tops Needs review.

Dermatology

Photos before the visit

Elm Street Dermatology asks new patients for close-up photos of the spot they want checked, and asks how fast it's changing only when they say it has.

Gastroenterology

Prep instructions, acknowledged

Bayview GI sends colonoscopy prep instructions with an agreement to confirm the patient read them. Reminders follow up by message and call, and stop once it's done.

On the record, always

Forms hold some of the most sensitive answers a patient gives. Ultradoc keeps track of everyone who touches them.

How Ultradoc protects patient data
  • Changes to forms and submissions are written to the audit log with who made them and when.
  • Opening a submission's files or its PDF is checked against the reader's access and recorded.
  • Only administrators build and publish forms. Seeing submissions takes the Patient App permission, set per role.
  • Photos in an answer stay hidden until someone chooses Show photos.
  • Signatures are stamped with the server's clock, never the device's.

Works with the rest of Ultradoc

Every part of Ultradoc reads from the same live record, so each one makes the others better.

Whatever your practice needs, Ultradoc does that.

Tell us how your practice runs. We'll set Ultradoc up around it and connect it to the EHR you already use.