🏥 DocSpeak FrontDesk – Clinic Onboarding Form

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1 Clinic Identity

Clinic Name

Main Contact (Name & Role)

Clinic Phone

Clinic Email

Website

Additional Contact Info

Clinic Address

Number of Providers

Average Patient Calls per Day

Staff Information

e.g., "Dr. Smith - Director, Nurse Jane - Head Nurse"

2 Hours & Operations

Regular Hours

After-hours Coverage

Yes, we provide after-hours/weekend coverage

After-hours Handling

3 Appointment Management

Booking new appointments

Cancelling appointments

Rescheduling

Sending reminders / confirmations

Waitlist management

Allow same-day urgent appointments

Require triage before urgent/same-day booking

Confirmation Method

Preferred Callback Timeframe

4 Triage Rules

Conditions Requiring Same-day Care

List conditions that always require same-day care

Non-urgent / Routine Conditions

List conditions considered non-urgent/routine

Emergency Red-flag Handling For red-flag emergencies (chest pain, breathing trouble, severe bleeding, stroke symptoms)

5 Prescription Refills

Handle refill requests

Refill Notice Period

Refill Fee Amount

Pharmacy Fax Number

Narcotics Policy

6 Medical Records

Patient Records/Results Requests How to handle patient requests for results/records

Turnaround Time (Business Days)

Chart Copy Fee

7 Services Offered

Walk-in clinic

Family medicine / chronic disease management

Minor procedures (sutures, mole removal, joint injections)

Prenatal & postnatal care

Vaccinations / immunizations

Addiction medicine

Aviation / immigration physicals

Anesthesia consults

Other Specialties

8 Price List & Payment Policies

Standard Uninsured Visit Fee

Insurance/Disability/School Forms Fee

Missed Appointment/Late Cancellation Fee

Chart Copy/Transfer Fee

Other Fees

Payment Methods Accepted:

Cash

Debit

Credit

E-transfer

Direct billing to insurer