📋 Patient Intake Forms

Extract patient data from intake forms — printed or handwritten

ParseMe reads demographics, insurance, allergies, and chief complaint from any intake form the moment it's scanned or photographed.

Try with your own forms ← Todos os documentos de Medicina e Saúde

⚡30% of front-desk time is manual data entry

Demonstração de extração ao vivo

parseme.co — patient_intake extraction

Patient Intake Form

PATIENT REGISTRATION — PLEASE PRINT CLEARLY

Patient Name: Gonzalez, Maria DOB: 03/14/1985

SSN: XXX-XX-4821 Sex: F Marital Status: Married

Address: 1440 Valencia St, San Francisco CA 94110

Phone: (415) 555-0193 MRN: 4821-KD

INSURANCE INFORMATION

Primary Insurance: Blue Cross Blue Shield PPO

Subscriber: Self Member ID: XZC-884210

Group #: 77341-A Employer: Pacific Design Inc.

HISTORY OF PRESENT ILLNESS

Chief Complaint: Persistent chest pain × 3 days

Associated Sx: Shortness of breath on exertion

Allergies: Penicillin Current Meds: Lisinopril 10mg

Hx: HTN (2019) · Family Hx: Father — MI at age 58

Dados extraídos

patient_name:Maria Gonzalez

date_of_birth:1985-03-14

mrn:4821-KD

insurance_carrier:Blue Cross PPO

member_id:XZC-884210

group_number:77341-A

chief_complaint:Persistent chest pain — 3 days

allergies:Penicillin

emergency_contact:Carlos Gonzalez (555-0193)

Todos os campos extraídos

Todos os campos que o ParseMe pode extrair de patient intake forms.

Campo	Tipo	Descrição
patient_name	string	Full legal name
date_of_birth	date	Date of birth (ISO format)
mrn	string	Medical record number
insurance_carrier	string	Insurance company name
member_id	string	Insurance member ID
group_number	string	Insurance group number
chief_complaint	string	Primary reason for visit
allergies	string	Known drug/food allergies
current_medications	array	List of current medications
emergency_contact	string	Emergency contact name and number
primary_care_physician	string	PCP name
address	string	Patient home address

O que você pode fazer com isso

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Outros documentos de Medicina e Saúde que o ParseMe processa

Cada tipo de documento do seu setor — tudo numa única plataforma.

💳 Insurance Cards

Front and back. Photo or scan. ParseMe reads every field on every insurance card — instantly at check-in.

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🧪 Lab Reports

ParseMe reads any lab printout and structures every test result with its value, unit, and range. Works with Quest, LabCorp, and in-house formats.

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💊 Prescriptions

Handwritten or printed. ParseMe extracts every field and routes the data to your pharmacy system automatically.

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🧾 Billing Statements

Parse EOBs and billing statements into structured data for faster coding, reconciliation, and collections.

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✍️ Consent Forms

ParseMe confirms who signed, what they consented to, and when — and routes each form directly into your document management system.

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Analise seu primeiro patient intake forms gratuitamente

Comece com 20 páginas grátis. Sem cartão de crédito.

Try with your own forms