Text boxesCollect short, single-line answers
Assistive technology intake & referral forms software
Build custom intake and referral forms, publish a link, and manage every response.
evalKeeper's assistive technology intake and referral forms workspace lets you build custom forms with the fields your program needs, publish a shareable link, and manage submitted responses by claiming them or assigning them to a team member.
Built for how assistive technology referrals actually arrive
Your intake and referral process should fit your program.
Build the form around the information you need instead of forcing your workflow into a fixed template.
Intake & Referral Forms are part of evalKeeper.
Custom forms live alongside the rest of your assistive technology workflow, so incoming referrals can stay connected to the process that follows.
Assistive technology programs often need intake and referral forms that reflect their own process, terminology, and information requirements. evalKeeper's form designer lets you build a custom form field by field using text boxes, text areas, checkboxes, radio button options, phone number fields, and standalone labels to organize the layout.
Each form can include its own header, subheader, and logo, with controls for whether those elements are displayed. Once the form is ready, publishing it generates a shareable link that can be posted on your website or sent directly to the people who need to complete it.
Submitted intake and referral responses stay organized with the form they came from and can be claimed or assigned to a team member for follow-up. A published form can also be unpublished at any time without losing its design or previously collected responses.
Custom intake and referral form fields
Build the form around the information your program needs.
Combine supported field types in the order that makes sense for your assistive technology intake or referral process.
Text areasCollect longer, multi-line responses
CheckboxesAllow one or more options to be selected
Radio optionsChoose a single answer from a set of options
Phone fieldsCollect a contact phone number
LabelsAdd headings and organize sections of the form
Intake & referral forms management capabilities
From custom form design to organized referral responses.
Create, brand, publish, share, and manage intake and referral forms without separating form design from the responses that come back.
Field-by-field form designer
Add text boxes, text areas, checkboxes, radio options, phone fields, and labels in the combination and order needed for your intake or referral form.
Required field validation
Mark individual fields as required so the form cannot be submitted until the information your program needs has been provided.
Customizable header and subheader
Set a header and subheader for each form and independently choose whether either one is shown to the person completing it.
Custom logo
Add an organization logo to the form and choose whether it is displayed on the published intake or referral form.
Configurable form layout
Arrange form fields so the finished intake or referral form presents information in a clear, logical order.
Publish with a shareable link
Publish a form to generate a direct link that can be posted on your website or shared with anyone who needs to submit an intake or referral.
Publish or unpublish anytime
Turn a form on or off without deleting its design or losing the intake and referral responses already collected.
Organized submitted responses
Every submission is saved as a response tied to its original form and submission date, with each answer linked to the question it came from.
Claim or assign responses
Claim an incoming referral response yourself or assign it to another team member so responsibility for follow-up stays clear.
Email notifications
Turn on email notifications and add one or more addresses to alert your team whenever a new intake or referral response is submitted.
Creation and update history
Each form records when it was created, when it was last updated, and who made those changes.
Multiple forms per account
Create and publish multiple intake and referral forms, each with its own fields, branding, shareable link, and submitted responses.
How intake and referral forms work
From custom form design to an organized referral response workflow.
Build the form your program needs, publish it for outside submissions, and keep incoming responses organized once they arrive.
Add text boxes, text areas, checkboxes, radio options, phone fields, and labels, marking required fields as needed.
Set the header, subheader, logo, and field layout to fit your intake or referral process.
Generate a shareable form link, then post it on your website or send it directly to the people who need it.
Review incoming submissions, claim a response, or assign it to another team member for follow-up.
Managing incoming intake and referral responses
Keep every submission organized and accounted for.
Once a form is published, evalKeeper helps your team keep new intake and referral responses connected to their source and assigned for follow-up.
Every response stays tied to its form
Each submitted response stays connected to the intake or referral form it came from and includes its submission date, keeping the original context easy to identify.
Claim it or assign it
Claim an incoming response yourself or assign it to a specific team member so responsibility for the referral is clear.
Get notified when a submission arrives
Enable email notifications so the people who need to know can be alerted when a new intake or referral response is submitted.
Answers stay linked to their questions
Each answer stays associated with the specific form question it came from, helping submitted responses remain organized even if the form is updated later.
Pause a form without losing its history
Unpublish a form to stop new submissions while keeping the form design and all previously collected intake and referral responses intact.
Frequently asked questions
Assistive Technology Intake & Referral Forms with evalKeeper
Learn how evalKeeper helps programs build custom intake and referral forms, publish shareable links, collect submissions, and assign responses for follow-up.
evalKeeper's intake and referral form designer supports text boxes, text areas, checkboxes, radio button options, phone number fields, and standalone labels for organizing sections of the form.
Yes. Individual form fields can be marked as required so the intake or referral form cannot be submitted until those fields are completed.
Publishing a form generates a shareable link that can be posted on another website or sent directly to someone. Opening the link takes the person to the published form so it can be completed and submitted.
Yes. A form's published status can be turned on or off without deleting the form design or the intake and referral responses already collected.
Yes. Each form supports a customizable header and subheader, with independent controls for showing or hiding them, along with an optional logo image.
The submitted response stays connected to its form and can be claimed by a user or assigned to a specific team member, helping keep responsibility for incoming referrals clear.
Yes. Forms can be configured to send email notifications to one or more addresses whenever a new intake or referral response is submitted.
Explore assistive technology intake and referral forms in evalKeeper.
Request a 30-day trial and see how custom intake forms, referral forms, shareable links, email notifications, and assignable responses can be managed in one connected workspace. No credit card is required.