Tired of doing data entry during client meetings? There's a better way.

Our Intake form is a simple, secure way to let your Medicare clients review and update their own personal info, drugs, pharmacies, and provider lists.

Any updates your clients make save to their Contact record in your account, so you're all set when it's time to meet.

You send a link: Send an Intake link to one client, or in bulk to many.
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They enter the form: clients enter a simple, mobile-friendly form flow.
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New clients fill it out: They complete the form from scratch, creating a new contact record in your dashboard.

Existing clients review & update: Clients see the info already on their Contact record – details, drugs, providers, etc – and can update anything that's changed.
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Updates auto-sync: Any updates a client makes sync to their contact record.
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SOA baked in: The form ends with a Scope of Appointment form.
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You get notified: You get an email when a client completes their form.

You can send a Personal intake link to existing Contacts. They'll see the data you have on record for them, and can update it.

Send to many contacts in bulk

On the Marketing tab, you'll find your Public Intake link. This is a universal Intake for all clients, new or existing. Perfect for marketing – drop it on your homepage, social media, email signature, etc.

The Public link first asks for the client's name and birthdate. If there's no match in your Contacts, the client fills out a blank Intake form, creating a new Contact record.

If a match is found in your Contacts, we email or text the client their Personal link so they can review and update what you have on file for them.

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Track Intake progress from your Contact records:

When a client submits an Intake form, any updates they make are recorded in the Activity Log at the bottom of their Contact record. Entries from Intake will show “Intake user” in the Who column.

You can use this to review exactly what the client updated, confirm accuracy, and resolve any questions or disputes down the line.

When you send the personal intake, the client receives an email or text that explains what they’re being asked to do. You can set a custom email message.

The email sender shows as your name – and the signature shows your info.

Or if you send it as a text, it'll show your name like this:

After clicking the link, they start on an intro page, explaining what this is for, with your name clearly identified as the agent. For Personal Intakes, this page asks for their birthdate, to confirm their identity.
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Clients review or add personal details – name, address, Medicare ID, etc.

Existing Contacts see any drugs you have on file for them. Here's how that looks:

Contacts without drugs on file can add them. To proceed, they must either add drug or select that they don't take any. (So you can be sure if they didn't add any, it was intentional.)

Adding drugs is easy – it's a senior-friendly, mobile-friendly, step-by-step flow:

Existing Contacts see any pharmacies you have on file for them. Contacts without pharmacies on file can add them. They can also select if they prefer Mail Order.

To proceed, they must either add a pharmacy or select that they don't have one.

They add pharmacies by searching the name within a zip code range.

Existing Contacts see any providers you have on file for them. Contacts without providers on file can add them.

To proceed, they must either add providers, or select that they don't have any.

They add providers by searching the name within a zip code range:

After completing drugs, pharmacies, and providers, Contacts see a page prompting them to complete a Scope of Appointment. Upon reaching this page, you'll get an email notification.

If a client exits before completing the form, any changes made up to that point are still saved to your records.

After the Almost Done page the Contact enters the standard Scope of Appointment flow, as described here. This ensures your meeting is CMS-compliant.

Client-facing pages like SOAs (and Intakes and shared quotes) will appear in Spanish if you've set the Contact's language to Spanish on their Contact profile. To do this, click Edit on the Contact profile to view the Language option and select Spanish.

If no language is set there, but their browser settings are set to Spanish, they'll see these pages in Spanish. To see a preview, add &lang=es to the end of a shared URL.

If you have access to contacts assigned to other agents – either because you're an agency admin, or you have Full Book access – you’ll see the option to email or text message the Intake as yourself or as the contact’s assigned agent.

This can be useful for backoffice staff sending on behalf of their agent team.

Q: What happens if an existing client enters the Public Intake link?

The Public link asks for name and birth date. If it matches an existing record, we'll send them their Personal link automatically – to avoid duplicates and keep their data secure. Here's how we choose the channel:

Q: Can I send the link to myself?
If you open an intake link in the same browser where you're logged in as an agent, you'll be automatically logged out. Instead, use the screenshots and documentation above to see what the client experience looks like. Or send it to yourself but open it in a different browser/device, or an incognito window.

Q: Am I notified when they complete the form?
Yes – you'll get an email when they finish the Intake portion, and another when they finish the Scope of Appointment.

Q: What happens if the client doesn't finish the form?
Any changes they make are saved automatically, even if they don’t finish the intake.
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Q: Does the link ever expire?
The public intake link never expires. The link sent to existing contacts expires 1 year after you first send it. You can resend a new link anytime.
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Q: Can the client change their entries once the form is completed?
Yes, they can re-enter the intake form and make new changes.

Q: Why do I need the client’s DOB to send the Personal Intake link?
Because it’s used to verify their identity when they open the link, ensuring secure access to personal data.

Q: Is this form mobile-friendly?
Yes, it’s designed to work well on smartphones and tablets.

Q: I tried to bulk send, but it says that some will be excluded, why?

We exclude anyone from a bulk send if they're missing an email, or missing a birth date, or if they've received an intake in the last hour. We also don't let you send to contacts that aren't yours (which you may have visibility to if you're an Agency Admin or have Full Book access). To see which particular clients are missing an email or birth date, do an Export.

Q: Can I send different intake links to the same email?

Yes – for instance for spouses who share an email.

Q: Does the client need to log into the form?

No, your clients don't need to log in to access the intake form. For personal Intake links, the client will need to enter their date of birth to get in.

Q: How can I tell what the client entered on the form?

You can see what they updated on the Activity Log – their entries are identified as being made by 'Intake user.'

If you have feedback on this feature or any others, let us know here.