Make first visits feel smoother from the very first click.
Give patients a simple way to complete intake forms, review policies, sign digitally, and even book appointments online. With flexible form building, smart conditional logic, and built-in automations, your chiropractic practice can spend less time chasing paperwork and more time helping people stand up straighter.

Make Intake Easy for Patients and Staff
Nobody wakes up excited to fill out paperwork. Good news: they don’t have to.
Create intake forms with clear sections, multiple question types, required fields, and a final thank-you page. You can also preview the form before sharing it, so everything looks polished before patients ever see it.
For chiropractic clinics, that means you can collect details like:
- New patient information
- Health history and symptoms
- Contact details
- Phone number for reminders
- Uploaded documents or images when needed
- Appointment requests or scheduling selections
Breely also supports client login, which can help pre-fill past information for returning patients and make repeat visits faster to manage.
Add E-Signatures With Confidence
Need signed consent forms, office policies, or acknowledgments? You can add a signature field directly to your form.
Once a patient signs, the form becomes:
- Digitally signed
- Timestamped
- Uneditable
You can also download a PDF copy of the signed form.
To make forms even clearer, place terms, policies, or consent language above the signature area using display text or an agree-to-terms field. It’s a simple setup that helps patients know exactly what they’re signing.
Build Smarter Forms for Different Visit Types
Not every patient visit is the same, and your forms shouldn’t be either.
Use conditional logic to show different questions based on earlier answers. For example, you can ask follow-up questions only if someone marks themselves as a new patient or indicates a specific concern.
You can also create multiple forms for different needs, such as:
- New patient chiropractic intake
- Returning patient check-in
- Virtual consultation requests
- Injury-specific history forms
- Staff-only internal booking workflows
Forms can be shared with a direct link, embedded on your website, or opened in a pop-up. If you prefer, you can even restrict access so a form only works when embedded on your site.
Simplify chiropractic intake with e signatures
Online booking, reminders, and payments — free to start
Connect Intake to Scheduling and Follow-Up
A good intake form doesn’t just collect information. It keeps your day moving.
Add an appointment question to turn your form into a booking flow, with options to customize how scheduling works and what patients can book. Appointment-related automations can then send confirmations, reminders, follow-ups, and updates after reschedules or cancellations.
Helpful automation options include:
- Email confirmations
- SMS reminders
- Follow-up messages
- Conditional sends based on form answers
- Webhooks for advanced integrations
That means fewer manual nudges from your front desk and fewer “Oops, I forgot” moments. A small miracle, honestly.

A Better First Impression for Your Practice
Modern chiropractic care deserves a modern intake experience.
With online forms, digital signatures, flexible question types, and automated communication, you can make it easier for patients to get started and easier for your team to stay organized. No paper stacks. No scanning marathon. No mystery handwriting to decode.
Ready to simplify chiropractic intake and collect e-signatures online? Start building a form that works for your practice and feels easy for your patients.
