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Patient Intake Forms

A branching patient-intake form — conditional sections that only appear when relevant (allergies unlock a follow-up, prior surgery unlocks a date picker), every field validated before the next section unlocks. A simulated encryption-status indicator shows the data moving through an encrypted state at each save, so patients see their information is protected without you having to explain the plumbing.

Generate a live preview

See a sample screenshot of Patient Intake Forms generated on the spot, in Lova's brand style. Optional: add a note to personalize it.

Own it, or go managed

Own It — one-time
$2,499

Full source code delivered via a secure, time-limited download link. Lifetime license, no recurring fees — you own it and self-host. 30-day email support included.

Zero maintenance
Managed — monthly
$79/mo

Hosted, monitored, and maintained by the Lova team — you never touch infrastructure. Includes uptime monitoring and minor feature patches.

Own it outright for $2,499 — no monthly fees, ever.

What's included

  • Deeply nested, conditional form sections
  • Field-level validation before section unlock
  • Simulated end-to-end encryption status indicator
  • Save-and-resume across sessions
  • PDF export for the patient chart

Built with

Astro TypeScript Vanilla JS Zod