Forms: Question Types

• You are able to set response types as the following:
  • Question Group: Add multiple questions to one page rather than 1-per page
  • Description: Add a description for a question(Not a question type, doesn’t accept a response)
  • Text: Free text response
  • Text (Long): Free text response with larger box
  • Number: Numerical response
  • Email: Patient’s Email
  • Phone Number: Patient’s Phone Number
  • Multiple Choice: Multiple Choice Response. You can have 1 or many responses required
  • Dropdown: Add multiple options for a dropdown
  • File: Allow the Patient to Upload a File
  • Files: Allows the Patient to Upload More than One File
  • Signature: Used for E-Signature and/or Uploading and E-Signature of a PDF
  • Date: Accepts a Date Response of (MM-DD-YYYY)
  • Date & Time: Allows you to select a Date & Time on a Calendar
  • Rating: Creates a sliding scale
  • Ranking: Creates a drag and drop stack ranking
  • Table Input: Lets you build a table to allow for multiple entries in one question
  • Address: Patient’s Address: Address Line 1, Address Line 2, City, State, Zip Code
    • Collect State Only: If you only want to collect a state for a Patient to determine their location, after selecting the "Address" Question Type, Check the box that says "Collect State Only"
      • Valid States: Allows you to specify whether certain states should be the only states visible for selection. This is useful when your business only serves select states.
    • Require Full ZIP: After selecting the Address question type, checking this box requires patients to input their full + 4 ZIP Code
  • Time: Allows you to select a time
  • Stripe: Allows you to display a Stripe payment page to collect a payment (Stripe integration required)
  • Database Select: Allows you to connect to a database you’ve created in Tellescope to pre-populate responses for questions and other information associated with that response
  • Medications: Connects to the National Library of Medicine’s Medication Database and allows patients to search for and add a list of Medications they’re taking
  • Related Contacts: Allows you to input information for a contact that should be created and associated with the patient who is filling out the form. Completing the question will automatically create a new contact and relationship if it does not already exist.
  • Insurance: Allows you to collect a patient's Insurance Member information and photos of their insurance card. The information collected through this question type can be passed to RCM vendors such as Candid and Canvas Medical.
  • Appointment Booking: This lets you specify a booking page to show to a patient that allows them to self-schedule from within the form.
  • Height: Patient's height, measured in feet and inches
  • Redirect: Allows you to redirect to an external URL (available for patient-facing forms only, not internal notes)
    Hidden Value: Allows you to collect a value that is not visible to the patient (for example, capture a value A if the patient progresses down one logic branch A in the form, value B if they progress down logic branch B)
  • Emotii: External tool that can be integrated to help assess emotional and physical health
  • Allergies: Allows you to utilize a searchable data source of allergies, as well as corresponding codes and information (Allergies managed through Organization>Contacts>Allergy Codes)
  • Conditions: Allows you to utilize a searchable data source of conditions, as well as corresponding codes and information (Diagnosis Codes managed through Organization>Contacts>Diagnosis Codes)
  • Rich Text: Allows patients to utilize a rich text input to provide more customized text-based responses.
  • Chargebee: Allows you to display a Chargebee payment page to collect a payment (Chargebee integration required)
  • Timezone: Allows patients to select a standardized US timezone (formatted as tz database time zones)

Form Question Description

• For a form question, you can optionally add a description. Using the editor you can include rich text, styling, hyperlinks, and page embeds.

Hyperlink

Emoji

File Upload / URL

•  Displays the image file uploaded or the image in the URL within the question description (as shown below)

Embed Link

• Allows you to iframe a website into the question description

Copying Response for Related Contacts

For a given form, if you're using the "Related Contacts" Type and you want the form responses to be added to the timeline of both the patient that's filling out the form and the related contact then you should select "Copy form responded to created contacts"