ACS Forms and Surveys

Modernize intake and feedback with Cliniconex Forms and Surveys—fully EMR-integrated to collect, connect, and coordinate patient data before and after appointments. Eliminate paperwork, improve compliance, and uncover insights effortlessly.

Cliniconex Forms and Surveys streamline intake, compliance, and feedback—empowering staff to focus more on care and less on paperwork.

Cliniconex Forms and Surveys

Modernize intake and feedback with Cliniconex Forms and Surveys—fully EMR-integrated to collect, connect, and coordinate patient data before and after appointments. Eliminate paperwork, improve compliance, and uncover insights effortlessly.

Connected Care, Front-to-Back Coordination

Say goodbye to manual forms and hello to streamlined data collection. ACS Forms makes it easy to gather patient information quickly and accurately using fully configurable digital forms—no printing, scanning, or chasing required. Combined with ACS Surveys, you can automate feedback collection after each visit to uncover insights, improve care, and reduce administrative workload

ACS Forms

Elimiate Paper Processes

ACS Forms allows your team to collect required information before the patient ever enters the clinic. Whether it’s consent forms, medical histories, or clinic-specific questionnaires, you can digitize your intake process and reduce bottlenecks at the front desk.

  • Custom Digital Forms: A fully configurable to your workflows, specialties, and intake needs.

  • Intuitive Drag-and-Drop Builder: Build and edit forms in minutes using a simple visual editor—no coding required.
  • EMR/EHR-Integrated Delivery: Automate form delivery based on your workflows and requirements.
  • Secure and Compliant: Forms are sent via secure channels and logged directly in your EMR.
  • Audit-Friendly: Automatically records completion, consent, and access trails.
  • Streamlined Workflows: Staff are alerted when forms are complete, no manual follow-up needed.
ACS Form Builder By Cliniconex

See Exactly What Matters to You

See what matters most to you. Every Cliniconex demo is tailored to your organization—focused on solving your challenges and showing exactly how our solutions work for your team.

ACS Surveys

Get Feedback Before, During, and After the Visit, Without the Work

Whether it’s before, during, or after a visit, ACS Surveys helps you gather feedback when it matters most. Automatically send surveys by email or text to capture insights on patient needs, satisfaction, and outcomes—without adding work for your team.

  • Flexible Delivery Options: Surveys can be automated, embedded in webpages, or manually triggered—whatever fits your process best.

  • Use Your Questions or Ours: Customize your surveys or start from our ready-to-use template library.

  • Built for Healthcare Workflows: Aligns with regulatory standards and quality improvement frameworks across care settings.
  • Measure What Matters: Gain insights into wait times, communication, and care quality.
  • Real-Time Alerts: Flag dissatisfied responses for timely team follow-up.
  • Track Trends Over Time: Monitor patient satisfaction scores and identify patterns to support continuous improvement.
ACS Form Builder By Cliniconex

Real-World Applications
That Drive Efficiency and Engagement

From intake and compliance to satisfaction and engagement—ACS Forms and Surveys automate everyday tasks across care settings, saving staff time while improving patient and family experience.

Collect resident dietary preferences to streamline meal planning.

Gauge resident outcomes and satisfaction after discharge.

Document key health and service updates following discharge.

Gather feedback on cleanliness and laundry service quality.

Allow residents or families to request rides for appointments or outings.

Let residents easily sign up for recreational or social activities.

Ensure visitors understand and agree to current safety protocols.

Digitally collect demographics, health history, and consent—no clipboards required.

Enable patients to review and update their info without tying up staff time.

Monitor symptoms and medication adherence between appointments.

Capture non-urgent concerns submitted outside business hours for next-day triage.

Understand patient concerns in advance to help providers focus and prepare.

Streamline the handoff from referring physicians with condition-specific intake.

Simplify seasonal campaigns with pre-sent digital consent and reminders.

Evaluate how well patients understood their discharge instructions and next steps.

Ensure staff have reviewed and acknowledged important training materials and policies.

Capture condition-specific details ahead of specialty appointments for more efficient visits.

Identify gaps in post-discharge care and spot patients at risk of non-adherence.

Send automated pre-procedure instructions to improve readiness and reduce cancellations.

Gather real-time feedback from admitted patients to support continuous improvement.

Enable patients or caregivers to request accommodations before their visit.