Complete the imported intake form without retyping every section.

This imported form was mapped from an outside source and grouped into reusable sections where possible.

Prefill preview is using Edna Chavarria from the Self household.

Vault autofill

Choose a household, then a saved member

Pick the household first so the member picker stays focused on the right family. Once you choose a person, the form will prefill any matching basic, school, medical, insurance, or emergency fields.

Clear autofill

Basic info

Use the same person-level details across school, medical, and care forms.

Full nameDate of birthEmailPhoneAddress

School info

Store classroom, student, and district details once and reuse them.

School nameGrade levelStudent IDTeacher or counselor

Medical info

Keep allergies, conditions, and provider details ready for intake packets.

AllergiesMedicationsConditions or medical notesPrimary physician

Emergency contact

Keep your backup contact details in a reusable block.

Emergency contact nameRelationshipEmergency contact phone

Household and pickup notes

Add the details that usually end up getting retyped across family paperwork.

Primary languageAuthorized pickup notesAdditional household notes

Imported fields

These fields were brought in from the source form and could not be mapped to an existing reusable section yet.

Additional Instructions

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