Custom Telepsychiatry Intake Form

I am a psychiatric nurse practitioner building a digital intake questionnaire for a telepsychiatry practice. The full intake questionnaire has already been written and structured. I am seeking a freelancer to convert the existing content into a well-organized digital form. This is a structured psychiatric intake form with multiple symptom screening sections and conditional logic. The wording and clinical structure must remain unchanged. The final form should be built using a third-party form builder (preferably Google Forms) so that it can be easily shared with patients and managed within Google Workspace. The form must be compatible with Google Forms and designed so that responses can be exported or printed as a structured PDF for clinical documentation. The questionnaire content and structure have already been finalized. The primary task is implementing the form using the provided questions, formatting, and instructions. I will upload the following materials: • A PDF and Word document containing the full intake questionnaire • Embedded form builder instructions within the document • My practice logo for branding The document already contains instructions for form logic, question types, and conditional display rules. The freelancer should carefully follow the instructions contained within the document when building the form. Form Content Overview The intake questionnaire includes multiple structured sections typically used in psychiatric intake evaluations, including: • Psychiatric symptom screening (DSM-based screening questions) • Medical history • Psychiatric medication history • Social and developmental history • Trauma history • Substance use history • Perinatal mental health screening • Treatment history and prior diagnoses Many sections contain conditional logic where additional questions appear based on patient responses. Some sections include multi-select symptom checklists, while others include text entry fields or radio button responses. The form will contain numerous conditional logic triggers to display follow-up questions when certain responses are selected. Key Requirements The freelancer must: • Preserve all wording exactly as written in the document unless clearly marked as form-builder instructions • Implement all conditional logic described in the instructions • Use appropriate question types (checkboxes, radio buttons, short text, long text, etc.) • Ensure the form works well on both mobile devices and desktop computers • Maintain clear section headings and organization for readability • Ensure the final form is easy for patients to navigate and complete • Implement conditional questions that appear only when triggered by responses • Ensure the form can be shared easily with patients through a link • Ensure responses can be exported or printed as a structured document for clinical review The interface should remain simple, clean, and professional. The goal is to create a patient-friendly intake form that collects detailed clinical information while remaining easy to complete. Structure Notes The intake questionnaire content has been divided into multiple sections to make the document easier to work with. These sections should be incorporated into a single continuous intake form in the final version. Headings should remain clearly visible to help patients navigate the form. Symptom checklists and structured screening sections should remain fully visible and should not be collapsed or converted into dropdown selections. Preferred Experience Preference will be given to freelancers who have experience with: • Google Forms or similar form builders • Complex form logic and conditional question flows • Healthcare or mental health intake forms Deliverables • Completed digital intake form • Ability for the practice owner to edit the form after completion • Form shareable via link • Responses exportable to PDF or printable format for clinical review My practice website is available here for reference so you can see branding and overall design style: [login to view URL] The intake form should visually align with this style but remain simple, clean, and easy for patients to complete. If you have experience building structured intake forms with conditional logic, please include examples of similar work if available. Please confirm in your proposal that you have experience with Google Forms section logic and will not restructure or modify the existing DSM symptom lists or clinical content.

Project ID: 40286168