Forms for Dermatology

Dermatology intake, filed before the exam.

Zentake digitizes dermatology intake, from skin-condition and sun-exposure history to photo consent and DLQI scoring. Everything a provider needs is ready before the appointment.

A patient acknowledgement form signed electronically in Zentake
Sent before the visitCompleted on any device
Photos uploadedStraight from the patient’s phone
Skin history completeSun exposure included, before the exam
Less admin, more care

Start the exam with the full history.

Condition history, uploaded photos, and quality-of-life measures are captured before the visit, so providers start informed.

Get started today

Complete skin history

Condition history, family history of skin cancer, and current medications captured up front.

Photo & document upload

Patients upload photos of lesions and prior records from their phone before the visit.

Quality-of-life measures

Auto-score the DLQI to track dermatologic impact over time.

The platform

A platform built for dermatology intake.

Everything you need to modernize patient onboarding while maintaining strict HIPAA compliance.

Customizable forms

Build dermatology history, consent, and new-patient packets from our library or create your own. Conditional logic keeps each form short and relevant.

Photo & file upload

Patients upload photos of lesions, insurance cards, and prior records straight from their phone. PDF, PNG, JPG, and HEIC all land on the record.

Quality-of-life measures

Auto-score the DLQI and other validated measures the moment a patient submits, with results filed in the record before the provider walks in.

Mobile friendly

Patients complete forms on any device before their appointment, saving time in your waiting room. No app to download and no portal account to create.

HIPAA compliant

Safeguard sensitive patient information with a BAA and advanced security, ensuring HIPAA compliance. Encrypted in transit and at rest, with full audit logging.

All-star support

Our experienced and friendly team is here to provide expert support whenever you need it. Setup takes under an hour, with a real human walking you through it.

User friendly. Convenient for our patients. Paperless is great.
Colleen C.AGNP-C
Get started

Start the exam with the full history.

Start your free trial, or book a walkthrough with our team. Setup takes under an hour, with a real human, not a chatbot.