Provider Profile, Online Intake & Referral Forms

$9.99 per month

30 day free trial

Protect patient health information with secure online forms.

Give clients and referring professionals a secure, convenient way to submit patient intake and referral forms online.

  • Professional Profile at MyofunctionalTherapist.com

  • Profile listed on Google and Yahoo!

  • Secure Referral Forms for Healthcare Professionals.
  • Appointment Requests & Inquiries with health info protected
  • Intake & refferal forms are completed and submitted online

  • Submissions are automatically added to your secure intake folder

  • View, print, or download completed forms

  • Email notified when a form is submitted.

  • Choose from our pre-made intake forms, plus get up to 3 of your own forms customized

  • A unique link to share your forms directly from your profile, website, or by direct link

  • HIPAA Secure

View, Print or Download Submitted Forms

Enjoy Full Access for Your First 30 Days!

Try everything, including MyoBooking.
After your trial, your membership continues at just $9.99/month.

Cancel before your 30-day trial ends and you won’t be charged.

No contract.  Cancel anytime

Add MyoBooking

$7.99 per month

30 day free trial

Let clients book directly from your profile, website, or booking link, with no limit on the number of appointments you can accept.

  • Booking Calendar directly on your profile
  • Multiple locations and services

  • Group or Course Sessions

  • Calendar Sync

  • Zoom, Google, Outlook, and Apple Calendar integration

  • Client Management

  • Private Internal Notes

  • Embed your calendar directly into any website

  • HIPAA Secure

Profile. Secure Forms.  MyoBooking.
All 3 for only $17.98 per month

Cancel before your 30-day trial ends and you won’t be charged.

No contract.  Cancel anytime