Form Builder

Form Builder

This is a Premium Patient Portal feature. For information about all features including printable PDF instructions for your office and your patients, please see our Premium Patient Portal Knowledge Base Article.
 
 
  1. IE (Internet Explorer) 8, 9, and 10 are not HIPAA compliant. We do not support these browsers.
  2. Please make sure your browser is fully updated.
 
 
Creating a Form
 
1. As a Portal Admin, log into the Patient Portal at https://patientonlineportal.com.

 
 
 
 
 
2. Click the  link. 

 
 
 
 
3. Select the  button. 

 
 
 
 
 
4.  (Steps 4 through 7 are optional - only required if you want to use a Header.) Click  in the top right to set the Header. The Header is an excellent place to put your logo.

 
 
 
 
 
5. (Skip if not creating a Header.) Drag an image into the box (or tap the blue bar to upload). Supported file extensions for images are .jpg, .jpeg and .png only. 

 
 
 
 
6. (Skip if not creating a Header.) You can adjust Alignment and Placement. Shown above, the header will be aligned in the right and the header will show only on the first page.
 
 
 
7. (Skip if not creating a Header.) Once the Header is set up, click the  button. 
 
 
 
 
8. Click the  button. This window will populate.

 
 
 
9. Type in a Form Name. 

 
 
 
10. Include Header turn on/off using the slider. (Header created in steps 4 through 7 above)

 
 
 
11. Choose which Folder you want the form in. This is where the form will be found in the Upload Site and ICANotes.

 
 
 
12. In the Parts section, click the  button. This is where you create the content of the form. 
 
 
 
13. Choose the first section of the form from the dropdown menu.

 
 
 
14. Click  button to continue creating the form.
 
  1. Text only selection:  
  2. Textbox selection:
  3. Radio buttons selection: After typing in the question, click the  button to fill out answers.
  4. Checkboxes selection: After typing in the question, click the  button to fill out answers.
  5. Dropdown list selection: After typing in the question, click the  button to fill out answers.
  6. Multiline textbox selection:
  7. Horizontal Line selection: While this does not show the horizontal line, on the preview/published form it will show the line. 
  8. Signature selection: This adds an area where the patient can sign using his/her mouse.
  9. The  button will cancel all changes and go back to Forms Builder page. 
  10. Clicking the  arrow on the left of the selection, will cause the Parts selection to collapse to  icon. When this icon shows, you are able to move around the Parts selection. (This does not appear for Edge, IE, Safari, and mobile devices. For these browsers/mobile device, use the  to move up or down.)
  11. Hover over the icon, and the crossbar will show as shown. 
    1. Once the crossbar shows, you can drag the Part to another area.
  12. Clicking the  button will delete the selection.
  13. Clicking the  button will copy the selection and place at the bottom of the Parts area.
 
 
 
 
15. Once you have created your form, click the  button.

 
 
 
16. When your form is ready, click the  button. You will receive an alert in the bottom right of the screen telling you that the form was published.  

 
 
 
17. Click the  button. Once this has been published, you will always be able to edit the form from the Forms Builder by clicking on the form name. Let's go back into the form. Click the form.

 
 
 
18. Under Availability choose if you want the form sent manually, always available, or available only once. 

 
 
19. Click the  button.
 
 
 
20. Once this has been saved, you will always be able to edit the form from the Forms Builder by clicking on the form name.

 
 
 
 
Manually Send Forms
​
1. Now we will send a form (or forms) to a patient. Click the  button. 

 
 
 
 
2. Search for your patient using Patient Name, Patient age between, Patient created between, or Patient appointment between. Click the  button after criteria has been input. 

 
 
 
 
3. Patients that meet the criteria show. You will notice that this patient was sent the Current Tobacco Use and Depression Assessment and Goals forms already. Let's send another one. Click the  button.

 
 
 
4. Select the form(s) to send to the patient and then click the  button.

 
 
 
 
5.  You will see that the form(s) has been sent to the patient. You will also see when a form has been completed.

 
 
 
Note: You can also use this area to see when a patient has registered for the portal. You can see the patients I circled have registered for the portal.

 
 
 
Let's visit the patient's Patient Portal
​
1. On the Patient Portal as a patient, click the Forms link on the top.

 
 
 
 
 
2. The patient will see forms listed on the left side. The patient will be able to fill out the form by clicking on it.

 
 
 
 
3. If you have built in a signature field, the patient clicks in the field and a popup window will populate where the patient can sign his/her name using the mouse. Once satisfied with the signature, click the 'Authorize Signature' button. 

 
 
 
4. When the patient is ready to submit his/her form, he/she clicks the  button. If the patient started to fill out the form but wishes to finish it later, click on the  button. They will be able to return to the Forms area at any time to finish the form and send (by clicking the  button).

 
 
   
 
 
How to obtain the completed form in ICANotes
​
1. From the patient's Chart Face, click the Documents tab. 

 
 
 
 
 
2. You will see the form in the list of documents.

 
 
 
3. Click the  button to see the completed form. Notice right-sided header, centered title, questions with answers, and patient signature.

 
 
 
 
How to obtain the completed form on the Upload Site
 
 
 
2. Find your patient on the left side. 

 
 
 
3. The form will be found under the folder you assigned in Step 11 of Creating a form.

 
 
 
Watch our video demonstration of the Form Builder:
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Watch our three form comparison video from the patient's perspective:

 

 


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