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Patient Intake Form Draft
A clear, welcoming intake form structure.
Universal
Claude
ChatGPT
Gemini
Grok
💡 The original prompt — works in any model. Start here, then tune per model.
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Practice
Needs
Draft an intake form for our practice. Practice type: {PRACTICE} What we need to collect (admin + scheduling): {NEEDS} Produce: 1. Sections in a logical order (contact, insurance/billing, consent-to-contact, reason for visit, etc.). 2. Clear, plain-language field labels and helper text. 3. A friendly intro line and a privacy note placeholder. Keep it short — only ask what's needed. NOTE: administrative template only, not medical or legal advice. Have your compliance/privacy person review it for your jurisdiction's rules before use.
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