On Line Enrollment form
- The form can be modified for your practice / PHO
- The Link to it is added to your website or emailed to your new patients.
- You can ask your new patients to complete their enrollment form on line then import the patient’s details into MyPractice.
- The on line form can include their signature and documented proof of eligibility (e.g. copy of their passport or birth certificate).
- The form can be downloaded as a PDF then saved in the patients record satisfying a audit requirements.
- The JotForms Online form service is free for up to 100 submitted forms per month
Create Your Form
- Go to the JotForms site and register yourself as a new user https://www.jotform.com/
- Create a form using our template (type ‘mypractice’ into the search box then select The MyPractice Enrolment form
- Add a QR code to your website or your practice
Customise the Form
Click on any section to select it then click on the edit button to the right
Add your own practice name , address and phone number
In the Enrollment section on page 2 update the form with your PHO name
Settings
In the Settings , remember to set your email address to receive the submitted form
Publish
Publish the form when completed
Copy the link to share and add this to your website or emails
Receive Submitted forms as email
Go to your email
Copy the patients details (highlight and press Ctl_C)
Get Details from the JotForms Site
Log into JotForms
Select the enrolment form, Go To the Inbox (on the right)
Select the Patient’s submission
Copy the patient details (highlight the text from ‘Name’ to the end of the form and Press CTL+C)
Import Patient Details
- Click New Patient
- Click On Import from Jotforms
- Paste into the text box and press [OK]
- Download the enrollment PDF from Jotforms site and import into patients record
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