Requires Admin permission for the Forms feature. Works with NexHealth Forms and Templates.

This article explains how to set up Smart Forms automation, how it behaves in different scenarios, and how to troubleshoot when forms don't send as expected.

What to know before you set this up

Smart Forms automation sends forms through your Reminders sequence - not at the moment a patient books. A few important limits apply:

Automation is form-by-form, not packet-by-packet. You toggle Send automatically on each individual form. Packets cannot be automated — they're for manual sending only.
Patients are prompted to confirm their appointment before completing forms. After confirmation, subsequent reminders carry only the form link.
If a patient's appointment changes after the reminder send window has already closed, automated reminders or forms will not send for that appointment. To ensure forms reach these patients, configure a secondary reminder cadence — for example, a reminder set to send 2 hours before the appointment — so there's still an opportunity to deliver forms after a late change.
Smart Forms reads NexHealth form completion history only. Paper forms completed in the office, and forms stored directly in your health record system, are not visible to Smart Forms. If a patient completes forms on paper, Smart Forms will still treat them as incomplete and may attempt to send digitally.
Different forms with similar names are tracked independently. A "New Patient Information Form" and a "Patient Information Update Form" have separate completion histories. Completing one does not satisfy the sending rule for the other.

Two ways new patient forms get sent

NexHealth has two distinct triggers for delivering forms to new patients. Understanding which one applies to your setup helps you avoid duplicate sends or gaps in coverage.

Trigger 1: New Patient template (chart creation)

When a new patient chart is created in NexHealth, the New Patient template fires automatically. If that template contains a form smart command (like INSERT_NEW_PATIENT_PAPERWORK_FORM), forms are sent at chart creation - before any appointment exists.

Trigger 2: Smart Forms via Reminders (appointment-based)

When a patient has an appointment and APPOINTMENT_REGISTRATION is in your Reminders template, Smart Forms sends forms as part of the reminder sequence. This trigger is tied to the appointment, not chart creation.

Trade-offs: The New Patient template sends forms immediately when a chart is created, even if no appointment is scheduled yet - this is fast but forms may expire before the visit. Smart Forms via Reminders waits until an appointment exists and sends forms closer to the visit, when patients are more likely to complete them.

If you're using Smart Forms via Reminders for new patients, remove the form smart command from your New Patient template to avoid duplicate sends. Go to Templates, open the New Patient template, delete the INSERT_NEW_PATIENT_PAPERWORK_FORM (or similar) placeholder, and save.

Set up automatic form sending

1. Navigate to Forms → Manage Forms and select a form.

The form builder opens with configurable rules in the right panel. You need Admin-level Forms permission to access Manage Forms.

2. Toggle on Send automatically.

You'll find this above the configurable rules on the right.

3. Click the edit (pencil) icon for each rule you want to configure.

You can set rules for:

Patient status — New or All patients. NexHealth considers a patient New if they have never had a completed appointment. Cancelled or missed appointments don't change their New status.
Frequency — How often the form repeats for existing/returning patients. Options include Every visit, Every 6 months, Annually, Only once, or a custom interval. The frequency timer starts counting only after a patient completes the form in NexHealth for the first time. Patients who have never filled out the form digitally in NexHealth are treated as first-timers regardless of how long they've been a patient — the form will send on their next qualifying appointment.
Age — Useful for sending different forms to minors (17 and under) vs. adults. When an age rule is set, the form only sends to patients with a known date of birth that falls within the specified range. Patients without a date of birth on file will not receive the form.
Procedure codes — Multi-select, OR logic: the form sends if the appointment includes any of the selected codes. Available for Athena, Cloud 9, Denticon, Dentrix, Dentrix Ascend, Dentrix Enterprise, Eaglesoft, eCW, Orthotrac, ModMed, and NextGen Office.
Appointment types — Same OR logic as procedure codes.

All rules combine as AND conditions. A form only sends when a patient satisfies every rule you've set. For example, if you configure a form to send to New patients and for Root Canal appointment types, the form will only send to patients who are both new and coming in for a root canal.

Heads-up on combining age rules with appointment type or procedure code filters: This combination can over-restrict form delivery. If a form is not reaching expected patients despite correct age settings, check whether the appointment type or procedure code filter is also excluding them. When in doubt, temporarily remove one filter at a time to isolate the cause.

4. Select your options and click Save.

Your rule is now active. Patients matching the rule will automatically receive the form as part of the Reminders sequence.

5. Repeat for each form you want to send automatically.

How patients receive automated forms

The APPOINTMENT_REGISTRATION smart command dynamically adjusts what each reminder contains based on the patient's current confirmation and form completion status.

Email reminders: Patients receive both an appointment confirmation request and a link to their forms in the same message.
SMS reminders: Patients first receive a request to confirm their appointment. If they confirm by responding "C", a form link is sent automatically right after. If staff confirms the appointment in your health record system instead, forms will be included in the patient's next scheduled reminder.
After confirmation: Subsequent reminders carry only any outstanding form requests. Once both confirmation and forms are complete, the reminder sends with no additional call to action.

Note on appointment status and automation: Smart Forms automation triggers based on the appointment's current status in the system — not its age, or whether a patient intends to cancel. If an appointment remains in an unconfirmed or any non-cancelled status, the reminder sequence will continue to fire and attempt to deliver forms. Automation only stops if the appointment is explicitly marked cancelled or deleted in your health record system.

How to turn off automatic form sending

To stop a specific form from sending automatically:

Go to Forms → Manage Forms.
Find the form you want to turn off. Forms with automated sending enabled show via reminders in the Send Automatically column.
Click the form to open the form builder.
Toggle off Send automatically.
Click Save.

Repeat for each form you want to disable. Turning off the toggle stops future automated sends but does not cancel form requests that have already been created.

Why didn't a patient receive their forms automatically?

NexHealth skips creating a new form request if the patient already has a form request expiring on the same date as their appointment. This is intentional - NexHealth assumes your staff may have already created a custom form request for that patient, and avoids duplicating it.

This applies even if the existing form request was already completed. If a patient completed a form request and that completed request expires on the appointment date, NexHealth will not create a new one for the same appointment. The form link will also not appear in the reminder for that appointment.

If you believe a patient should have received forms but didn't, check these:

Is APPOINTMENT_REGISTRATION in your Reminders template? Go to Templates and inspect the reminder message body. This command must be present for forms to be included in reminders.
Does at least one form have a sending rule that matches this patient's appointment? Check that the patient status, appointment type, procedure code, and age rules all align with the patient's actual appointment details. Remember that all rules combine as AND conditions.
Did the patient complete the form on paper? Smart Forms reads NexHealth completion history only. Paper forms don't count — the system will still see the form as incomplete and may attempt to send again.
Does the patient have an existing form request — completed or not — expiring on the same date as the appointment? If so, NexHealth intentionally did not create a new one. Use manual form sending instead.
Did the appointment type change after the reminder send window closed? If so, no forms or reminders will send for that appointment. Send forms manually or configure a secondary reminder cadence to catch late changes.

Troubleshooting issues with new patient paperwork

If a new patient isn't receiving their forms, confirm the following:

Install and run the NexHealth Synchronizer — ensure it is installed and actively running.
Log in to NexHealth before creating the patient profile.
Save the patient profile — open it after creation and click Save. This connects the profile properly and enables form sending.
Confirm both that the patient exists in NexHealth and that their appointment is scheduled.

Frequently asked questions

How does NexHealth determine if a patient is New or Returning?

A patient is New if they have never had a completed appointment. Cancelled or missed appointments don't change their New status.

Will a patient receive multiple forms if they match multiple rules?

Yes — they receive every form whose rules they satisfy. Each qualifying form is included in a single combined link, so the patient opens one link and completes all their forms in one session.

Can I automate packets?

No. Automation is configured per individual form, not per packet. When multiple forms are triggered for the same patient, NexHealth groups them into a single link automatically — no packet setup needed. Packets remain useful for manual sending.

Can I use procedure codes instead of appointment journeys to trigger forms?

Yes. Form automation rules with procedure code filters can replace appointment journey mappings for sending forms. Use Appointment Journeys if you need customized message content tied to specific appointment types — not just different forms.

Does form automation work with all health record systems?

Form automation works with all systems that support NexHealth-integrated forms. Procedure code and appointment type filtering availability varies by health record system.

Will Medical History forms pre-fill for returning patients?

Yes. If a patient previously completed a NexHealth Medical History form, the next one will pre-fill their previous answers. They only need to update anything that has changed.

If I swap the form version in a packet (for example, switching to a Spanish-language version), when does that take effect?

Changing the form included in a packet only affects future manual sends from that packet. It does not update automated form sends, which are controlled by each individual form's sending rules — not by packet contents.

Do I need to check in a patient before consent forms are sent?

No. Automated consent forms are sent through the Reminders sequence before the appointment, so check-in status has no effect on them. For forms that need to go out at or after check-in, send those manually.

Can I trigger follow-up forms based on a patient's answers?

No. NexHealth cannot automate form requests based on responses to other forms.

How do I cancel a form request if a patient filled out paper forms instead?

In Forms, search for the patient, click the ellipsis (…) next to the request, and select Archive.

Can I stop sending New Patient forms?

To remove New Patient forms from automated sending, edit the template that contains the form placeholder. Look for ALL CAPS placeholder text like INSERT_NEW_PATIENT_PAPERWORK_FORM or INSERT_NP_FORM, delete it, and save the template. Check your Save the Date and Reminders templates too if forms continue sending.

If you'd prefer forms to go out only when a patient has an appointment scheduled (not on patient creation), configure a Smart Forms rule instead:

Navigate to Forms → Manage Forms and select the New Patient form.
Toggle on Send automatically.
Set the Patient status rule to New.
Confirm APPOINTMENT_REGISTRATION is present in your Reminders template.

This ensures New Patient forms are sent as part of your appointment reminder sequence rather than when the patient is first created.

How do I send forms automatically?