Independent Clinic Patient Intake, Treatment Estimate & Review QR Pack

Independent Clinic Patient Intake, Treatment Estimate & Review QR Pack

By Snowfield • Author: Jordan Masopust, Indianapolis, IN

Instant Digital Download • Price: $15.00

Built specifically for solo medical, dental, chiropractic, physical therapy, and wellness clinics. This coordinated package provides high-contrast 14-point patient intake paperwork, a compliant Good-Faith Treatment Estimate financial consent form, a professional countertop review QR stand, and front-desk recall scripts to rapidly build 5-star Google review velocity.

What is included in this download:

• 2-Page 14pt patient intake form: Health history, red-flag alerts, and insurance coverage
• Good-Faith Treatment Estimate breakdown with financial consent and signature block
• 8.5x11 inch countertop Google Review QR display sign with front-desk display instructions
• 6 Front-desk patient review scripts for SMS, post-visit email, and reception desk handoff
• Strictly compliant with healthcare privacy guidelines; zero patient health data exposed

Product Highlights:

• Universal Compatibility: Works cleanly in Microsoft Excel 2016+, Office 365, and Google Sheets.
• Laser-Safe Printing: High-contrast typography with 0.5-inch margins for clipboards and binders.
• Complete Privacy: No macros, scripts, external cloud links, or subscription charges.
• Direct Support: Created by Jordan Masopust (jordan.masopust@gmail.com).