Medicare & ACA Intake

An automated process that streamlines client health information gathering.

Collect health data, doctors, and e-signatures in one secure link. No more manual entry, everything syncs straight to your CRM.

HIPAA Compliant
CMS Approved
256-bit Encryption
SOC 2

How it works

Three simple steps from link to CRM — no training required.

Step 01

Agent sends a link

Generate a branded intake link from your dashboard and share it via text or email.

Step 02

Client fills out info

Clients complete demographics, prescriptions, doctors, and compliance forms on any device.

Step 03

Data syncs to your CRM

All responses flow into your CRM automatically with full audit trails and compliance records.

SOA & Consent Management

Digital Scope of Appointment, Permission to Contact, and ACA consent with e-signatures.

Doctor & Pharmacy Lists

NPI-validated provider search plus pharmacy lookup by ZIP code.

Year-Over-Year History

Returning clients verify last year's data instead of re-entering everything from scratch.

CRM Auto-Sync

Every form submission pushes data to your CRM with full field mapping and audit logs.

Medication Optimization

Fuzzy search across 88+ medications with dosage, frequency, and condition linking.

Multi-Product Support

Medicare Advantage, Part D, ACA, and supplemental plans in a single configurable flow.

1,200+

Surveys completed

24

Agents onboarded

15,000+

Medications tracked

Ready to modernize your intake?

Get started in minutes. No setup fees, no long contracts.

Get Started