Registration that’s done before the patient walks in.
Send a pre-visit form via WhatsApp, SMS, email, or QR. Collect demographics, Emirates ID, insurance, and clinical history once — and the front desk has a complete chart on arrival.
Patient chart · ready on arrival
Mariam Al Suwaidi
مريم السويدي
Emirates ID
784-1985-3829471-1
MRN
MRN-014902
Date of birth
14 May 1985
Phone
+971 50 123 4567
Insurance · verified via DHPO
Daman Premier
Member · DAM-394821 · valid through 2027-04-30
Allergies
Penicillin, latex
Current meds
Metformin 1g BD
Chronic
T2 DM, HTN
Last visit
14 Mar — Dr. Khalid
What gets captured.
Five categories. Patient fills the parts only they know; DHPO eligibility lookup confirms insurance against the Emirates ID; receptionist verifies exceptions.
Identity
- ·Full name (EN + AR)
- ·Date of birth, gender, nationality
- ·Emirates ID (784- format validated)
- ·Passport (for tourists / new arrivals)
Contact
- ·Primary phone, alternate phone
- ·Preferred language (AR / EN / HI / UR / TL)
- ·Preferred channel (WhatsApp default)
Insurance
- ·Carrier (Daman / Thiqa / NEXtCARE / 18 more)
- ·Member ID, policy number
- ·Card photo (uploaded for billing record)
- ·Coordinator review for low-confidence matches
Clinical
- ·Reason for visit
- ·Allergies (drugs, latex, food)
- ·Current medications
- ·Chronic conditions, surgical + family history
- ·Smoking, alcohol
Compliance
- ·PDPL consent (timestamped + language-tagged)
- ·Data-sharing preferences (per-purpose)
- ·Marketing opt-in (separate from clinical)
- ·Audit log per field, per visit
One form. Four ways to reach the patient.
The same form template is delivered through whichever channel the patient actually uses. The data lands in the same chart either way.
Token-gated link sent right after the booking confirms. Patient taps once, fills once.
SMS link
Same link, plain SMS. Falls back automatically when WhatsApp delivery fails.
Email + QR
Patient opens on a laptop, attaches the insurance card photo from desktop.
In-clinic kiosk
iPad at reception loads the same form for patients arriving without a pre-fill.
What it actually solves.
No more 8-minute front-desk intake
By the time the patient sits down, the chart is open with insurance verified, allergies flagged, MRN on the wristband. Receptionist confirms identity and routes them in.
No duplicate patients
Emirates ID is matched against existing records on submit. Same-EID, same patient — no second MRN, ever. Family / dependents linked to a primary policyholder so insurance lookups roll up correctly.
No PDPL audit gaps
Consent is timestamped per field, per visit, in the patient's chosen language. When DHA or PDPL ask, the audit log answers in seconds — not weeks.
Built for the UAE clinical landscape.
PDPL 2021
Consent capture is timestamped + language-tagged per field. Audit log queryable per patient, per visit.
Emirates ID 784- format
Validated client-side. Tolerant of paper IDs and tourist patients. Match-on-EID prevents duplicates.
DHA · DOH · MOHAP
Regulator metadata captured at clinic onboarding. Flows automatically into every claim, every consent record.
Bilingual native, not translated
Forms render in EN or AR with proper RTL. Field labels, hints, errors all flip cleanly. Khaleeji-friendly.