Module 2 - Patient Intake Portal

Description

Discover how to configure and use the 4D EMR patient portal. Learn to send invitations, customize intake forms, and manage digital workflows for both new and existing patients—including in-office digital intake via TEPE.

Key Topics

• Sending and managing portal invitations
• Customizing portal settings and forms
• Intake and health information workflows
• In-office digital intake (TEPE)
• Where portal data lives in 4D

Please note: The outlines below are intended to supplement the linked videos and are not standalone documentation.

2.0  Intake Portal Overview (0:46)

2.1  Sending Portal Invitation (0:51)

How to Send a Patient Portal Invitation

Sending an Invite When Creating a New Patient

• During new patient creation, after entering their information:
  • Ensure you have collected both a phone number and an email address.
  • Select the option “Send a Portal Invite.”

Sending an Invite from the Appointment Schedule

• If the patient already has an appointment:
  1. Right‑click on the appointment.
  2. Navigate to Contact Patient.
  3. Select Send Portal Invite.

Sending an Invite from the Patient Summary

• From the appointment:
  1. Right‑click the appointment.
  2. Select Patient Summary to open the patient’s summary page.
• In the Demographics tile:
  • Choose the option to Send Portal Invitation.

General Notes

• Portal invitations can be sent to patients at any time, regardless of appointment status.

2.2 Portal Walkthrough (7:55)

Portal Walkthrough — Outline

 Overview

• After sending a portal invite, the walkthrough demonstrates the patient’s experience.
• This demo reflects the default portal setup when first using 4D.
• Portal configuration options will be covered later in the module.

 Patient Notification & Access

• The patient receives both an email and a text message indicating they have forms to complete.
• Collecting a valid email and phone number is required for portal access.
• The email sent contains a secure link to the portal.
• Patient is prompted to enter their date of birth to verify identity.
• If DOB was not collected during intake, the patient cannot access the portal.
• The patient confirms they are the correct individual.

Portal Home Page

• Patient sees the number of forms they need to complete.
• Optional: Upload Photos
• Upload from device library or take live photos.
• Patient proceeds to complete their assigned forms.

 Completing Assigned Forms

 Form List Examples

• Health Information Form
• HIPAA Notice
• Treatment Consent
• (Your database can include additional or custom forms.)

 General Form Signing Process

• Patient acknowledges that digital signatures are legally enforceable.
• Each form displays:
  • A digital copy for review.
  • Auto-filled date and printed name.
• Patient signs using the yellow signature box.
• Options:
  • Complete to sign.
  • Prefer not to sign if they have questions for the practice.

Health Information Form Walkthrough

 Patient Identity

• Patient selects whether they or a parent/guardian is completing the form.

Demographic Information

• Patient reviews and updates:
  • Address
  • Phone number
  • Email
• Communication preferences:
• Voicemails
• Appointment reminders
• Permission to use email/text for PHI
• If yes, a security warning appears.
• Patient must check I agree to proceed.

Marketing Preferences

• Patient chooses whether to receive marketing texts/emails.

Reason for Visit

• Patient enters:
• Reason for visit
• How they heard about the practice
• Primary care provider information

Allergies

• Options include:
• Latex
• Tape
• Medication allergies
• For patient medication allergies, a table appears when they select Add Medication where they can add the following: 
• Medication name (search-assisted)
• Reaction type
• Additional comments

Current Medications

• Patient lists all medications, including over-the-counter items.

Surgical History

• If yes, a table appears requesting information from the patient: 
• Surgery name
• Complications
• Year performed

Medical History Questionnaire

• Patient enters:
  • Height
  • Weight
• Questionnaire includes ~70 default questions (customizable).

Additional Medical Conditions

• Patient may list any conditions not covered in the questionnaire.

Social History

• Smoking
• Alcohol use
• Recreational drug use

• Marijuana can be separated as its own category.

Family History

• Issues such as:
• Blood clots
• Anesthesia complications
• Additional family medical history can be added.

Final Acknowledgment

• Patient confirms the form is completed to the best of their ability.
• Signs in the yellow signature box.
• Selects Finish.

Optional Patient Survey

• Patient is offered a 3‑question survey about their experience.
• They may skip or complete it.

 Completion & Downloads

• All forms are now complete.
• Patient can:
  • Select View next to any form.
  • Download copies to their device.

2.3  Where Portal Items Live

Where Portal Items Live — Outline

Overview

The previous content demonstrated the patient portal experience from the patient’s perspective. This section explains where the submitted information is stored in 4D for your practice to review.

Nearly all portal‑submitted items live in the Patient’s tab of your database.

Appointment Indicators

• After logging into 4D and viewing the test patient’s appointment:
• The H and U symbols disappear once the patient completes their Health Information and Consent forms.
• A new allergy icon may appear if the patient reported allergies.

 Accessing the Patient’s Account

• Navigate to the Patient’s tab in the top right.
• Pull up the patient’s account by searching:
  • Name
  • Account number
  • Date of birth
• Additional search tools:
  • Magnifying glass → Advanced search
  • Clock icon → Recently accessed patients
  • Plus symbol → Create a new patient (not needed in this module)

 Patient Summary Page

• Once the patient account is opened, the Patient Summary appears on the left.
• The Patient Demographics tile is now populated with the information submitted through the portal.
• Examples:
• Allergy to penicillin
• Past surgery such as appendectomy
• Before portal completion, these fields were blank.

 Editing Patient Demographics

• Navigate to Profile → Details to view or edit:
  • Name
  • Address
  • Phone number
• If the patient agreed to PHI communication via email/text, a confirmation box displays the date of consent.
• To update information:
• Select Edit Profile
• Make changes
• Select Save 

Alerts, Comments, and Optional Fields

• Patient Alerts
  • Select Edit Alerts to add alerts.
  • Alerts appear in the top left whenever the patient is scheduled or accessed.
• Admin Comments
  • Internal notes for staff; not visible to the patient.
• Appointment Comments
  • Auto‑populate on every appointment block.
• Optional Fields
• Expand this section to toggle additional items.
• Many fields appear based on portal configuration.

 Accessing Clinical Information

Navigate to the Clinical tab to review health‑related data.

 Medical History

• Includes:
• Allergies
• Medications
• Past medical history
• Social history
• Family history
• All items can be manually edited.
• Select Save after making changes.

Review of Systems

• Displays the ~70 medical history questions from the portal.
• Any Yes responses appear at the top for quick review.

Vital Signs

• Shows:
• Height
• Weight
• BMI
• To add new vitals:
1. Select + New Intake
2. Enter information
3. Save
• Creates a running vital history record. 

Forms and Scans

• Navigate to Forms and Scans → View and Import.
• Here you’ll find PDF versions of:
• Health Information Form
• HIPAA Notice
• Consent to Treatment
• Selecting the PDF icon displays:
• The completed form
• The patient’s digital signature
• As long as the patient completed the forms correctly, they are stored and accessible here.

2.4  Portal Email Options (1:42)

Portal Email Options 

Overview

When you send a portal invitation to patients, they will receive an e‑mail where they can select the link and access their portal forms.

This section walks through the settings you can configure for those emails.

Accessing Email Configuration

To adjust or customize these settings, navigate to:
Practice Settings → Patients E‑mail Options

A new window will appear that allows you to make changes to the emails patients receive.

Branding and Display Options

• If you'd like your logo to appear in the e‑mail instead of the default patient portal invitation logo, select Change Logo and upload it from your computer.
• If you'd like to hide the office address and phone number on the e‑mail, toggle the Hide Office Address and Phone option.
• This is especially helpful if you have multiple office locations.

Sender Information

• You can change the sent by name.
• By default, the e‑mail will be signed off with the main provider’s name.
• If you toggle the box, you can change this to your business name or a different staff member.

Email Text Options

• The system provides default text that patients will see in their portal invitation email.
• You can preview this by selecting the Preview option to the right of Use default text.
• The text shown in the red box is what is currently being sent to patients.
• If you prefer to customize the message, toggle the Custom Text option and begin writing your own text in the field below.

Saving and Testing

• Once your changes are complete, select Save near the top of the page.
• You can also send test emails to yourself to preview how the logo and custom text will appear to patients by selecting the Send button near the bottom of the page.

2.5  Configuring Portal Settings

Configuring Portal Settings

Overview

During the Patient Portal walkthrough, we mentioned that the Health Information form can be customized to better fit your practice needs.

This section shows exactly where those settings live and what you can adjust.

We recommend sending a new Health Information form to your test patient so you can see changes in real time.

There is no right or wrong way to set up the portal—use this guide to understand your options and configure the portal in the way that best supports your practice.

Accessing Portal Configuration

To begin customizing the Health Information form, navigate to:
Practice Settings → Patient Portal Options

At the top of the settings page, you’ll find options that impact the form as a whole.

Global Form Settings

• You can display an additional warning at the top of medical pages, reminding patients to provide complete health information.
• You can choose between Arial or Times font for portal text.
• If you’d like your practice logo displayed at the top of the portal, upload the file here.

Form Notification & Button Styling

• The portal tells patients how many forms require their attention.
• By default, this appears as a blue button with black text.
• You can personalize both the button color and text color using the color wheel or by entering a HEX or RGB code.
• The Upload Photos button is enabled automatically.

• If you do not want patients to upload photos, you can disable it.
• You can also adjust the button and text colors.

Demographic Information Settings

The form begins by requesting demographic details.

You can choose to include additional fields such as:

• Gender identity
• Marital status
• Occupation
• And more

Because practices vary widely, we generally recommend toggling on Emergency Contact details and then enabling additional items that make sense for your workflow.

Some fields include an Include in HPI option.
When enabled, patient responses will be included in chart notes when configured appropriately.

Reason for Visit & Consult Options

• By default, patients can type in their reason for the visit.
• If you prefer a structured option, you can turn on List of practice consult reasons.
• This requires additional setup, covered in a separate video.
• We recommend enabling the Referring Doctor text box, which gives patients more flexibility than a predefined list.

You can also enable up to two custom visit‑related questions and choose whether to include the answers in the HPI.

Optional visit‑related questions include:

• Whether the patient has visited your website
• Whether they’ve consulted other doctors
• Their understanding of the service or procedure
• Desired timeframe
• Interest in financing
• Interest in additional services

Insurance & Primary Care Information

• If your practice accepts insurance, toggle on Insurance Card Information so patients can upload their details.
• Insurance configuration is covered in another module.
• You may also choose to collect primary care information:
• Primary care provider name (text box recommended)
• Phone number
• Date of last visit
• If your practice needs specialist information, toggle on the relevant categories.

• These remain optional for patients.

A preview is shown in the video of what the page looks like with all options enabled.

Medical History Configuration

You can ask patients for:

• Their highest recorded weight
• Additional female health questions (only shown if sex at birth = female)

You may edit:

• The instructions for the ROS section
• The prompt for Active Medical Conditions
• The Medication question
• Whether to collect preferred pharmacy information

Additional options:

• Enable Set All to No for medical history questions
• Not recommended, as patients may skip important information.
• Change ROS display style:
• Standard red/green buttons
• Simplified black/white checkboxes
• Enable questions about adverse reactions to anesthesia
• Enable a question about past hospitalizations
• Ask female patients about hormonal birth control
• Enable a detailed medication table (name, dose, reason, frequency, duration)

Social History Configuration

You can customize:

• Wording for smoking, alcohol, and recreational drug prompts
• Whether to include frequency questions

We recommend enabling marijuana use questions, as patients often do not list marijuana under recreational drugs.

You may also ask up to three custom social history questions.
Many practices use these to ask about:

• GLP‑1 medications
• Weight loss drugs
• Hormone therapy

Family History Configuration

You can modify questions related to:

• Bleeding history
• Anesthesia reactions
• Family, genetic, or chronic conditions

If detailed family history is needed, turn on the Detailed Family Conditions table.
A separate video explains how to build this table.

We also recommend enabling the Disclosure Box, allowing patients to list individuals with whom you may share medical information.

Signature Page

You can modify the attestation text on the signature page.
A standard version is provided, but you may adjust it to fit your practice needs.

Saving & Testing

Once you finish configuring your portal options, select Save.
Your updates will apply to all future patients.

You can continue testing changes as you work or send a new Health Information form to your test patient.

2.6  Editing Review Of Systems

Edit Review of Systems 

Overview

Now that you have a better understanding of the patient portal, this section explains how to configure your Review of Systems (ROS) questions.

As a reminder, these questions appear in the patient portal under Medical History.

By default, 4D provides approximately 70 pre‑built questions, but these may not fit your practice needs.

This walkthrough shows how to edit, remove, and create ROS questions that better support your workflow.

Accessing Review of Systems Settings

Navigate to:
Practice → Charting → Review of Systems

You will now see:

• The name of your provider
• The list of ROS questions that appeared during the portal walkthrough

Each provider can have their own customized Review of Systems.

Selecting a Provider

First, select the provider whose ROS questions you want to edit.

You can change the order of the questions by selecting the arrows to the left of each description.

We recommend following a structured order when building out your ROS list.

Deactivating Unneeded Questions

Start by deactivating any questions you do not need.

To deactivate:

1. Click on the description text of the question
2. A new window appears
3. Toggle off the Active button near the top
4. Select Save

The question will no longer appear for patients.

Creating New Review of Systems Items

After removing unneeded items, create questions that fit your practice needs.

To create a new item:

1. Select the + New icon near the top
2. A new window appears

Display Text

• The Display Text field controls how the item appears to the patient
• Enter your example item here

The “patient admits/denies” phrases will auto‑populate based on your text.
You should adjust these phrases to match your practice’s preferred wording.

System Category

• Assign the item to a System Category
• Categories cannot be modified
• Choose the category that best fits your item

Optional Configuration Settings

You can set conditions for when a ROS item appears.

Examples include:

• Sex‑based restrictions
• e.g., only show if the patient is female
• Age limits

• e.g., only show for patients above or below a certain age

Additional options:

• Toggle Patient Alert if you want the item to trigger an alert
• Add the item to Patient Medical History

• If enabled, search for the appropriate medical history entry
• An ICD‑10 code will appear

Once configured, select Save.

Adding Sub‑Questions

You can add sub‑questions to any ROS item.

To add a sub‑question:

1. Select the + icon to the right of the item
2. A new window appears

When the Sub‑Question Appears

Choose the condition:

• If you select Yes, the sub‑question appears only when the patient answers “Yes” in the portal

Creating the Sub‑Question

1. Enter the text for the additional question
2. The admits/denies phrases will auto‑populate
3. Adjust these phrases as needed

You may also:

• Toggle Patient Alert
• Add the sub‑question to Patient Medical History

Select Save when finished.

Best Practices

• It is important to edit your ROS items so you can gather relevant, accurate patient information.
• We recommend deactivating unnecessary questions first, then adding new items.
• Once complete, patients will see and answer your updated medical history questions in the portal.

2.7  TEPE (Total Electronic Patient Entry) (2:15)

TEPE (Total Electronic Patient Entry) 

Overview

The Total Electronic Patient Entry portal, or TEPE, is designed for patients who need to complete their portal forms in the office.
You can also use TEPE to quickly add forms for patients to sign and complete.

TEPE is intended for use on a tablet, but it can also be accessed on a computer if needed.

Accessing TEPE

TEPE is accessed through a separate website from 4D.

1. Go to tepe.4d-emr.com in your web browser.
2. On your tablet, log into TEPE using the same email and password you use to log into 4D.

Do not hand the tablet to the patient yet—first, you need to pull up their information.

Selecting the Patient

On the next page:

1. Select the provider.
2. If the patient has an appointment that day, their name will appear automatically.
3. You can also search for the patient by selecting All Patients and typing their name.

Confirm identifying information with the patient to ensure you have selected the correct person.
Toggle the confirmation bubble and select Next.

Reviewing and Adding Forms

The next window displays the list of forms the patient needs to complete.

• New patients should see their Health Information Form listed.
• If your Forms Library is set up correctly, you can add additional forms on the fly using the Treatment Consents and Other Consents tabs.

• (This workflow is covered in the Forms Library module.)

Review and add any required forms, then select Go.

Handing the Tablet to the Patient

You will see a notification indicating that you may now hand the device to the patient.

The patient can then begin completing their forms.

From this point forward, TEPE looks and functions exactly like the patient portal they would access from home.

• Patients cannot access any other patient information.
• They may complete their forms or choose to log out.

After the Patient Finishes

Once the patient is done, they will return the tablet to you.
All completed information will now be available inside your 4D database.

Summary

TEPE is an extremely helpful tool for patients who need to complete their forms in the office and for practices that want a streamlined, tablet‑friendly workflow.

2.8  Marketing Referal Sources (1:09)

Marketing Referral Sources 

Overview

During the portal walkthrough, one of the referral options available to patients is Internet.

When selected, it allows the patient to choose where on the Internet they learned about your practice.

Out of the box, 4D provides only two options: Website and Internet.

This section explains how to add additional Internet referral sources.

Accessing Marketing Referral Settings

To add more Internet referral sources, navigate to:
Practice → Admin → Doctors and Staff

To the left of the provider’s name, select the calendar icon.
This opens a new page.

Adding New Internet Referral Sources

On the right-hand side of the page, you will see a heading labeled Marketing Referral Sources.

This is where your Internet referral list lives.

1. Select + New
2. A new field will appear
3. Add additional Internet referral sources such as:

• Instagram
• TikTok
• Facebook
• Any other online platforms relevant to your practice

The Active box keeps the referral source active throughout the system.

Toggle on Shared to ensure all providers have access to these referral options for their patients.

Select the blue check mark to save.

Repeat these steps until you have added all desired marketing referral sources.

Availability in the Patient Portal

Once completed, your new Internet referral sources will be available for patients to select from inside the patient portal.

2.9  Edit Consult Reasons (1:11)

Edit Consult Reasons

Overview

This section reviews how to edit your Portal Consult List, which was introduced in the Portal Configuration section. 

These settings determine which consult reasons appear for patients inside the portal.

Accessing Consult Reason Settings

Navigate to:
Practice → Admin → Doctors and Staff

To the left of the provider’s name, select the calendar icon.

The next page loads your schedule options, where you can modify your consult reasons.

Editing Portal Visibility

If you want a consult reason to appear in the patient portal:

1. Hover over the Patient Portal Category column
2. Select the appropriate category from the dropdown

If you leave the Patient Portal category blank, the consult reason will not appear in the portal.

Adding New Consult Reasons

If you need to add additional consult reasons:

1. Select the + New icon to the right of Consult Reasons
2. Enter the description of the consult
3. Ensure the Active box is toggled on so it is usable throughout the system
4. If you want to share this consult reason with other staff members, toggle on Shared
5. Select the appropriate Patient Portal Category if you want it visible to patients

Select the blue check mark to save.

Summary

Once saved, your new or updated consult reasons will be available for use throughout the system and, if configured, will appear in the patient portal.