A2V2
A2V2

Patient intake that fills itself in

Build custom intake forms, let AI pull patient data straight from uploaded documents, and turn every conversation into a structured record. All inside HIPAA-compliant infrastructure.

A2V2
Forms/New Patient Intake
Completed
Patient Information
Full Name
Sarah Mitchell
Date of Birth
04/12/1989
Gender
Female
Primary Goal
Hormone Optimization
Height
5'6"
Weight
132 lbs
Submitted Jul 8, 2026
View Record

Build the exact forms your clinic needs

Create custom intake and assessment forms with a simple drag-and-drop builder, no technical setup required.

Drag-and-drop fields
Text, number, checkbox, radio, dropdown, date, and more.
Built for clinical intake
Create new-patient forms and advanced assessments alike.
Encrypt sensitive data
Toggle per-form encryption so sensitive fields are protected at rest.
A2V2
Form BuilderNew Patient Intake
Fields
Text Field
Number
Date
Dropdown
Checkbox
New Patient Intake
Full Name
Text Field
Date of Birth
Date
Primary Goal
Dropdown
+ Add field
A2V2
AI ExtractionProcessing
patient_intake.pdf
2.4 MB
AI Extracting...
Full Name
Michael Torres
AI Extracted
Date of Birth
06/15/1976
AI Extracted
Primary Concern
Fatigue, low energy
AI Extracted
Height
5'11"
AI Extracted
Review and Submit

Let AI do the data entry

Upload a PDF, Word doc, or intake document and A2V2 extracts the details and fills in the matching form automatically. No more retyping what a patient already gave you.

Upload and extract
Drop in a document and the form populates itself.
Faster, more reliable intake
Patient details land in the record quickly and dependably.
Review before it saves
Extracted data becomes a draft submission your team can confirm.

Turn conversations into records

When a patient starts a conversation, your agent can verify their identity by email and automatically create a contact record, so intake begins the moment they reach out.

Chat-based intake
Patients begin intake through a natural conversation.
Email verification
Verify the patient by email before assisting.
Auto-created records
A verified conversation becomes a CRM contact automatically.
A2V2
A2V2
A2V2 Agent
Online
Welcome! To get started, please share your email address for verification.
sarah@email.com
Thanks! A verification code has been sent to sarah@email.com.
4721
You are verified. A contact record has been created for you.
Contact CreatedVerified
Sarah Mitchell
sarah@email.com
LeadSource: Chat
Created just now via in-chat intake

Your agent reads and writes the right fields

Mark specific form fields as AI-accessible so your agent can read and update exactly the data it should, and nothing it should not. It is precise control over what the AI can touch.

Field-level access control
Choose exactly which fields your agent can read or write.
Stable machine names
Each field has a consistent name your agent uses to reference it.
Precise read and write permissions
Grant read, write, or both on a per-field basis.

Intake data, protected at every step

Every form, every extracted field, every chat record is handled inside A2V2's HIPAA-compliant infrastructure.

HIPAA
HIPAA Compliant
Built for healthcare from day one. BAA provided on every plan, with full audit trails.
AES-256
AES-256 Encryption
All data encrypted at rest and in transit using industry-standard AES-256 and TLS 1.3.
BAA
Secured LLM Access
AI runs under a Business Associate Agreement. Your data is never used to train models.
U.S.
U.S. Data Centers
All patient data is stored in U.S.-based data centers with complete access controls.
Learn more about our security →

See intake that fills itself in

Book a demo and we will show you AI-powered intake and everything else A2V2 can do for your clinic.