Extract data from patient intake forms

A patient intake form is the packet a clinic hands a new patient on a clipboard, and it is the front door to the medical record. Front-desk and medical-records staff retype these by the hundred, because the data on them has to land in the EHR before a visit can be billed: patient demographics, the insurance carrier and policy number, the reason for the visit, the medical and medication history, allergies, and the signed consents. A primary-care practice or an urgent-care chain onboarding patients all day receives intake forms as completed paper scans, PDFs filled in a portal, and faxed packets from referring providers, each laid out differently and many in a patient's own handwriting. The challenge is that an intake form mixes structured fields, checkbox grids, and free text, often handwritten. Demographics are discrete (name, date of birth, address, phone), but the medical history is a checkbox list where a patient ticks conditions such as hypertension or Type 2 diabetes and adds notes in the margin. Medication and allergy lists are free text, and a missed allergy is a safety issue. The insurance section carries a carrier such as Aetna, a member ID, a group number, and a policy holder relationship that has to map to the right billing fields. Consent and HIPAA acknowledgment sections need a signature and a date to be valid, and an unsigned consent has to be caught at intake rather than discovered at billing. Talonic reads the intake form and returns demographics, insurance, history, medications, allergies, and consent status as structured fields, with checkbox grids captured as selected and unselected items and handwriting scored for confidence, so front-desk staff confirm rather than transcribe. A patient seen 2026-05-30 with a 1968-02-14 date of birth hands over demographics, an Aetna member ID, and a history the front desk keys into the EHR; the US clinic stores PHI in the EMR, tags the provider NPI, scans the PDF, runs OCR, checks the consent, and bills the CPT codes in USD.

What gets extracted from patient intake forms

How extraction works for patient intake forms

Patient intake forms come from clipboard scans, patient-portal PDFs, and faxed referral packets, so a single template never holds across practices. Talonic classifies the form and maps it to the patient-intake schema in the Field Registry, which separates demographics, insurance, clinical history, medications, allergies, and consent. Checkbox grids for the medical history are captured as selected and unselected items rather than flattened to text, and handwritten free-text fields such as medications and allergies are returned with per-field confidence so a low-confidence entry is flagged. The insurance block maps the carrier, member ID, group number, and policy-holder relationship to the billing fields a practice management system expects. Consent and HIPAA acknowledgment sections are checked for a signature and date. Every value returns with a confidence score and pixel-region provenance under DIN SPEC 91491 conformity, so staff verify a captured allergy or policy number against the source form.

Sample extraction

A scanned two-page new-patient intake packet

{
  "patient_name": "Helen Park",
  "date_of_birth": "1968-02-14",
  "address": "4120 Cedar Lane, Austin, TX 78704",
  "phone": "+1 512 555 0147",
  "insurance": {
    "carrier": "Aetna",
    "member_id": "AET558210934",
    "group_number": "GRP-88231",
    "policy_holder": "self"
  },
  "reason_for_visit": "Annual physical and blood pressure follow-up",
  "medical_history": [
    "hypertension",
    "type 2 diabetes"
  ],
  "medications": [
    "Lisinopril 10 mg",
    "Metformin 500 mg"
  ],
  "allergies": [
    "penicillin"
  ],
  "consent": {
    "signed": true,
    "signed_date": "2026-05-30",
    "hipaa_acknowledged": true
  }
}

Frequently asked