Forms & intake
Intake forms that look like your practice.
Your questions, your colors, your type, on a plain link or right inside your own website. Patients don't make an account, and what they answer arrives as structured data instead of a stack of paper to retype. Try restyling the form on the right.
Yours to shape
Your questions, in your words.
The form builder is for a practice's actual intake, not a generic clinic's. Change anything the patient sees and it's live on the same link.
- Nine question types: short and long text, email, yes/no, pick one, pick several, date, number, and percentage
- Half-width and narrow fields, so first and last name or city and zip share a screen instead of stretching across it
- Hints and placeholders that explain a question without cluttering it
- Your own welcome title and a thank-you message, with an optional button back to your site or booking page
- Progress saves on the patient's device, so a long form can be finished later
Templates
Start from a form written for a treatment room.
Quick and comprehensive new-patient intake and a pediatric health history are ready to preview, with no account. Add one to Goji and it becomes your own editable copy; your changes never affect the template.
- Browse and try each template live before you commit to it
- Every template is a starting point to adapt, not legal or medical advice
On your website
Put the form on your own site, dressed to match.
Skip the link-out. A short guide in the form builder helps you pick colors, corners, and a font, shows a live preview, and hands you one snippet to paste into your site.
- Works in any page that accepts HTML: WordPress, Squarespace, Wix, or plain HTML
- Sizes itself to each question, so there's no empty space or inner scrollbar
- Answers go straight to Goji and never touch your website or its scripts
- Fires events your site can listen for, to track a submission or send the patient to a thank-you page
Agreements & signatures
Get the agreement and the signature in the same visit.
Add a terms block the patient has to scroll through before agreeing, and turn on a required signature for a typed name and a drawn one.
- Each signature is stored with the exact wording it was signed against, plus a timestamp and the submitter's IP address and browser
- You write the wording. Goji doesn't give legal advice, so have your own advisor review what you ask patients to sign
After submission
From submission to patient record, without retyping.
A submission doesn't create a patient by itself. It lands in an inbox where staff create a new patient from it, attach it to an existing one, or dismiss it in a click. Custom fields map onto the same fields your patient and session records already use.
Patient intake form questions, answered.
Do patients need to create an account to fill out an intake form?
No. Every form has its own link. A patient taps it, answers, and they're done, with no account, password, or app to download.
How much can I customize a form?
Everything patient-facing: the questions and their order, the question types, which short fields share a screen, the welcome and thank-you text, and an optional agreement or signature step. When you put a form on your own website you can also set its accent color, background, corner roundness, and font to match your brand.
Can I put a form on my own website?
Yes. Copy a short snippet into any page that accepts HTML, such as WordPress, Squarespace, or Wix. The form runs on Goji and is shown inside your page, so patients' answers go straight to Goji and never pass through your website or its scripts.
Can I collect a signature?
Yes. Add a terms block the patient has to scroll through before agreeing, and turn on a required signature to collect a typed name and a drawn signature. Each signature is stored with the exact wording it was signed against, a timestamp, and the submitter's IP address and browser. Whether an electronic signature is enough for a particular document depends on where and how you practice, so check with your own advisor.
What happens after a patient submits a form?
It lands in a Form submissions inbox rather than creating a patient automatically. Staff choose to create a new patient from it, attach it to an existing one, or dismiss it, so a duplicate or a no-show never becomes a half-finished patient record.
Can a patient finish a long form later?
Yes. Progress saves to their device automatically, so reopening the same link later picks up where they left off. Goji also won't let the same link submit twice from the same device.
Do I have to write every form from scratch?
No. Start from one of the free intake templates, which you can preview without an account, then reword, reorder, add, or remove questions in your own copy.