✨ Sample project by Trustform Digital — a fictional practice, for demonstration only.
Getting started

A calmer way to
start your care.

Cedar Park Family Medicine welcomes you. Complete your new-patient intake ahead of time, so your first visit is unhurried and focused on you.

Private & encrypted

Your information is encrypted the moment you enter it and only your care team can see it.

Only what's needed

We ask for the minimum necessary to care for you — nothing more.

Sign in seconds

Review and sign your consent forms electronically — time-stamped and audit-logged.

About 5 minutes Save & resume anytime

About you

Let's start with the basics so we can create your secure patient record.

These details are encrypted before they ever leave your device.

Insurance & pharmacy

So we can verify your coverage and send prescriptions to the right place.

Insurance details are stored in an access-controlled vault, encrypted at rest.

Your health history

A brief history so Dr. Reyes is prepared before you arrive.

Upload your documents

Add a photo of each. Files are encrypted on upload and scanned automatically.

Stored in an access-controlled vault. Only Cedar Park's authorized staff can open them.

Review & sign

Confirm your details, then review and sign your consent to complete intake.

Consent to Treat & Notice of Privacy Practices
Please scroll to read the full document
Your signature *
Sign in the box above.
Please read the document, check the box, and add your signature.

You're all set, there.

Your intake is complete and your consent has been securely recorded. Dr. Reyes will see you at your appointment — a copy of your signed consent is on its way to your email.

Electronic Signature Certificate Tamper-evident
Consent audit trail
Please complete the required fields.
Secure patient intake — a sample build by Trustform Digital Want this for your practice? Book a free call →
Exit demo