Technology · Intake Forms
One intake. 0+ conditions.
The clinical front door of your brand: a conversational intake with conditional logic, photo capture, and safety gates built by clinicians — every completed flow routed to a licensed provider on a 15–60 minute SLA.
GLP-1 eligibility · question 12 of 14
Any personal or family history of medullary thyroid carcinoma or MEN2?
Try it
Run a real intake, right now
These open the live demo store in a new tab — same engine, sample data, nothing stored.
Whole-care intake
One entry point across the full catalog — pick a goal, get the right flow.
Start the flowGLP-1 weight loss
The deep flow: history, safety gates, GLP-1 eligibility, titration-ready.
Start the flowMental health
Mood and focus with the 988 crisis red-flag built into the logic.
Start the flowSame-day visit (UTI)
An acute visit — fast triage, urgent-care red-flags, same-day script.
Start the flowClinical guardrails
Smart enough to say no.
An intake that only converts is a liability. Ours qualifies — and disqualifies — with clinical rules on every answer.
Conditional logic
Every answer routes the next question — a 60-second flow for the healthy path, real clinical depth where it matters.
Clinical red-flags
Disqualifying answers stop the flow and route to in-person care — MTC/MEN2 history gates GLP-1s, nitrates gate ED treatment, crisis answers surface 988 immediately.
Photo capture
Dermatology and other visual conditions collect photos inside the flow, so the clinician reviews a complete chart on the first pass.
Routed on an SLA
A completed intake lands in a clinician queue routed by state licensure and condition — reviewed in 15–60 minutes.
The architecture
Five tiers, one chart
Every condition runs the same layered engine — that's how 160+ intakes stay clinically consistent instead of becoming 160 separate forms.
Universal intake
Identity, vitals, allergies, medications — asked once, reused everywhere.
Gender-gated branches
Flows fork only where clinically relevant — no wasted questions.
Symptom wrapper
Structured symptom capture — onset, duration, severity, context.
Condition review
A condition-specific review of systems for each of 160+ conditions.
Rules & safety
Decision rules and safety gates run across every answer before a clinician ever sees it.
160+ conditions · 14 decision rules · 39 safety gates — maintained once, inherited by every brand on the platform.
Embed anywhere
Drop your intake on any page.
Two lines of code turn any landing page, blog post, or funnel into a clinical front door — the widget opens your branded intake in a modal, wired straight to clinician review.
Prefer a full storefront? That's built too — see e-commerce.
<script src="https://embedcare.com/embed.js" async></script> <a data-embedcare="yourbrand">Start your visit</a>