Forms for Pediatrics

Pediatric intake parents finish before the visit.

With Zentake, parents complete pediatric intake at home on their phone, from well-child histories to developmental screeners. Your team starts each visit with immunization records, e-signed consents, and auto-scored screeners already in hand, no clipboard at check-in.

A pediatrician greeting a young patient while a parent looks on
Screeners auto-scoredM-CHAT-R and Vanderbilt on submit
Guardian consent signedBefore the well-child visit
Completed at homeOn the parent’s own phone
Less admin, more care

Start the visit, not the paperwork.

Guardians complete developmental and medical history from any device before the appointment, so your staff spend less time chart-prepping and more time with families.

Get started today

Parents fill out at home

Guardians complete developmental and medical history from any device before the appointment.

Developmental screening

Auto-score the M-CHAT-R, Vanderbilt, and ASQ-3 with follow-up logic for at-risk responses.

Guardian consent

Capture guardian signatures for treatment, vaccines, and release of information with timestamps.

The platform

A platform built for pediatric intake.

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

Customizable forms

Build well-child, sick-visit, and new-patient packets from our library or create your own. Conditional logic keeps each form short and relevant to the visit.

Developmental screeners

Auto-score the M-CHAT-R, Vanderbilt, and ASQ-3 with structured follow-up for at-risk responses, filed in the chart before the appointment starts.

Guardian e-signatures

Collect legally binding guardian signatures for treatment, vaccines, and records release. Every signature is timestamped, audit-logged, and ESIGN compliant.

Mobile friendly

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

HIPAA compliant

Safeguard sensitive family 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.

The ability to create developmental forms so parents can complete them at home. Also the ability to integrate that information directly into the EHR, which means less chart prepping for my staff.
Annalise C.ARPN, CPNP
Get started

Start the visit, not the paperwork.

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