Kit contents
HIPAA Therapy Intake Kit
- 01Branching intake by therapist, visit type (in-person vs telehealth), and presenting concernform
- 02Sliding-scale fee disclosure block (cash-pay) with insurance card upload (insurance)form
- 03Mental-health history with current medications, prior providers, and first-time vs returning logicform
- 04PHQ-9 and GAD-7 baseline screening with auto-scoringform
- 05Telehealth-only block: tech check, video consent, platform preferenceform
- 06Separate dated consent form (telehealth risks, no-show, ROI, privacy notice) with e-signatureform
- 07Patient confirmation with first-session expectations - zero PHI in bodyemail
- 08Front-desk notification - 'new submission, click to view' with no clinical content in emailemail
- 09Therapist notification - PHI-stripped, links to authenticated Jotform viewemail
- 10Resume-link email if the patient abandons mid-formemail
- 1124-hour pre-visit reminder (telehealth pre-visit kit handoff for video sessions)email
- 12Conditional branching invisible to the patient - one continuous form that adaptsworkflow
- 13Auto-routing of submission to the named therapist + office manager onlyworkflow
- 14PHQ-9/GAD-7 high-score flagging for clinical review before first sessionworkflow
- 15Consent expiry tracking with annual re-consent promptworkflow
- 16Audit-trail notes on every submission for licensing-board readinessworkflow
- 17Jotform HIPAA plan (Gold or Enterprise) with signed BAA - requiredintegration
- 18SimplePractice and TherapyNotes via structured CSV batch importintegration
- 19DrChrono and Athena via webhook + API for real-time intakeintegration
- 20PHI-safe storage (encrypted Drive folder under BAA, or Jotform-only retention)integration
- 21Calendar handoff to Google Calendar, Calendly, or SimplePractice schedulingintegration
- 22Bilingual intake (English + Spanish) with mirrored branchingextra
- 23Mobile-first design tested on phones and tabletsextra
- 24Printable patient-facing summary for personal recordsextra
- 25Decision-log template documenting every BAA in the data pathextra
