Online forms


With online forms, your clinic can securely collect information from prospective or existing patients. The information that a prospect or patient provides on such forms can then be reflected automatically in a new patient file, or in the patient's existing file. The forms, once submitted back to the clinic, can be reviewed, processed, and archived by clinic staff. Online forms requests can be sent to email addresses of prospects, patients, and patients' alternate contacts; alternatively, they can be sent to appropriately configured clinic tablets, to be completed at the clinic.

Your clinic can use online forms in a number of ways:

  • Online forms can be associated with appointment types, so that the creation of an appointment of the right type, or a user's verification of an incoming online booking of the right type, will prompt the sending of the appropriate online forms.
  • From the Patient drop-down menu, online forms can be sent to existing patients independently of appointments in the calendar. 
  • From the Online forms module, online forms can be sent to any email address, independently of any appointments in the calendar, and independently of any patient files in your system. 
  • Each online form in your system will have its own URL and iFrame HTML, allowing you to distribute the form directly online for respondents to find, fill out, and submit. This capability can, for example, be used for lead capture by call center agents, who won't require Blueprint OMS user accounts in order to access the online forms.

Blueprint OMS online form templates

Your clinic can get started with online forms by using any of the online form templates that come with Blueprint OMS. These are region-specific; the US forms are listed below.

  • COVID-19 pre-visit survey
  • Contact us form
  • Demographic intake form
  • HIPAA and insurance consent
  • Hearing handicap questionnaire (HHQ12)
  • Hearing inventory screening questionnaire for adults
  • Medical history intake form
  • Medical waiver
  • Speech, spatial, and qualities of hearing scale survey (SSQ12)
  • Tinnitus handicap inventory survey

To learn how to set up custom online forms, see: Creating online form templates: PDF and Creating online form templates: Word.

What patients see

The recipient will receive a secure link to the forms on request in an email as below. The email template is customizable in the Setup > Online forms > Settings menu, and user can add individualized messages in specific forms request.

If the forms request is for a patient who has a date of birth on file, the recipient will be asked to enter the patient's date of birth in order to proceed to the forms. The wording will take into account whether the recipient is the patient or the patient's alternate contact.

If the recipient has authenticated with the patient's date of birth, then a suitably configured form will pre-populate existing information about the patient. For a QuickAdd with no date of birth on file, existing information will not pre-populate. The patient will be able to complete, sign, and submit the forms on request.

Once the clinic receives the forms back, the recipient of the forms request will receive another email. The template for this email is also customizable at Setup > Online forms > Settings.

Terms and conditions

PDF technology powered by PDFTron WebViewer SDK copyright © PDFTron™ Systems Inc., 2001-2020, and distributed by Blueprint Solutions, LLC under license. All rights reserved.

The Blueprint OMS end user:

  • Will use the PDFTron software only as an integral component of Blueprint OMS;
  • Will not use the PDFTron software for development, compilation, debugging and similar design-time purposes;
  • Will not reverse-compile or decompile, analyze, reverse-engineer, reverse-assemble or disassemble, unlock or otherwise attempt to discover the source code or underlying algorithms of the PDFTron software or attempt to do any of the foregoing in relation to the Object Code of the Software; and
  • Will not modify, adapt, translate or create any derivative works of the PDFTron software.
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