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Live demo

Watch a real intake fill in.

The chat below runs the same engine that powers production intakes — same streaming, same field capture, same safety escalation. No PHI, capped at our monthly demo budget.

Configure your intake form, then run it — this is the same builder customers use.

Form details

Name and behavior that apply to the whole intake.

Words that trigger a human handoff (e.g. "chest pain").

Fields (5)

#1full_name

Always asked. Add a condition to branch on an earlier field's answer.

#2date_of_birth

Always asked. Add a condition to branch on an earlier field's answer.

#3reason_for_visit

Always asked. Add a condition to branch on an earlier field's answer.

#4pain_level

Always asked. Add a condition to branch on an earlier field's answer.

#5current_medications

Always asked. Add a condition to branch on an earlier field's answer.