With the Demographics form and Credit card information form, you can collect clients' personal, contact, and payment information through the Client Portal. Information submitted through these forms is saved to the client’s profile.
In this guide, we'll cover:
- Demographics form overview
- Customizing the Demographics form
- Configuring optional and mandatory fields on the Demographics form
- Credit card information form overview
- Managing a paper version of the Demographics or Credit card information form
Note: To learn more about the paperless intakes in SimplePractice, see Sending intake forms and documents to clients and Sharing documents with multiple clients and contacts.
Demographics form overview
The Demographics form can be sent to clients at any time and allows them to provide their personal and contact information through the Client Portal.
What clients can enter
When completing the Demographics form in the Client Portal, clients can provide the following information:
- Legal first name
- Legal last name
- Middle name
- Indicate if the client is a minor
- Email address
- Phone number
- Address
- Date of birth
- Relationship status
- Employment status
- Emergency contact information
Clients can also choose whether to receive email, text, and/or voice notifications and reminders from your practice.
Where the information is saved
Any information submitted through the Demographics form automatically populates into the client’s profile in your account. For more information, see Editing a client's information.
Customizing the Demographics form
You can customize the Demographics form by choosing which optional fields are available to clients and which fields are required to submit the form.
Optional fields
Optional fields let you collect additional information when needed.
Name they go by
This field allows clients to enter the name they go by in addition to their legal name. In your account, the name they go by appears in place of the legal first name on the calendar, the client’s profile, and on billing documents.
Note: The client’s legal name appears on insurance claims.
Insurance
If the Insurance section is included, clients can enter their insurance information and upload images of the front and back of their insurance card.
This section won’t appear if insurance information already exists in the client’s file. You can enter new insurance information from the client’s Overview page > Edit > Billing and Insurance tab.
Note: If you’d like an existing client update their insurance information through the Demographics form, you’ll need to delete the insurance information from their Billing and Insurance tab, then resend this form.
The insurance section of the Demographics form the What sex is on your insurance policy? field, which is required for insurance billing purposes.
Gender identity
This field allows clients to provide their gender identity, pronouns, and related information. Entries are limited to 140 characters.
Mandatory fields
You can require clients to complete specific fields before submitting the Demographics form. When marked as mandatory, clients must complete the selected fields before they can submit the Demographics form. Required fields are indicated by a red asterisk.
The following fields can be made mandatory:
- Phone number
- Address
- Date of birth
- Emergency contact's name
- Emergency contact's email
- Emergency contact's phone number
Note: Legal name and email address are mandatory by default and can't be changed.
Additionally, if you have Insurance enabled as an optional field, you can choose to require:
- Insurance information, including insurance payer, member ID, sex, and relationship to insured
- Insurance card upload
Configuring optional and mandatory fields on the Demographics form
You can add optional fields and set mandatory fields for the Demographics form. To edit the Demographics form:
- Navigate to Settings > Documentation > Shareable documents
- Under Demographics and Credit Card, click the 3 dots and select Edit next to the Demographics form
- Under Which fields should be included in the form?, check the boxes next to the optional fields you want to include
- Under Which fields should clients be required to answer?, check the boxes next to the mandatory fields you want to include
Click Save
Credit card information form overview
If you use online payments, you can securely request client credit card information using the Credit card information form.
What clients can enter
When completing the Credit card information form, clients can enter their credit card details. The submitted information is encrypted, and the full card number isn’t displayed or viewable by anyone in your account.
Where the information is saved
After the form is completed, the card type, last 4 digits, and expiration date are saved to the client’s Billing and Insurance tab.
Tip: If a client has multiple cards on file, you can set a default card and add a nickname to help distinguish between them.
To request updated credit card information from a client, you can resend the Credit card information form through the Client Portal.
Important: The Credit card information form doesn’t include a signature box. To authorize payment processing, you can use a separate Credit Card Authorization consent form. For more information, see Default consent form templates.
Credit card information should only be stored in the PCI-compliant fields in the client’s Billing and Insurance tab. If credit card information is stored outside of these designated fields, you acknowledge the risk associated with storing this data in your account.
Managing a paper version of the Demographics or Credit card information form
If you'd like to provide a paper version of the Demographics form or Credit card information form to your client:
- Click on the form you'd like to share with the client:
- Select Make a copy
- Edit the form to your needs
- Print the form and provide this to the client
Once the client completes the form(s), you can enter their information into the client's Overview > Edit page according to their answers. For more information, see Editing a client's information.
Note: You’ll only be able to add a card to the client’s file if you have online payments enabled. After you enter the information, only the last 4 digits of their credit card will be visible. To learn more about our PCI-compliant Online Payments feature, see Getting started with online payments.