Components
Installation
$ pnpm dlx shadcn@latest add @pdfcn/takumi/medical-intake-form
Usage
import { MedicalIntakeFormDocument } from "@/components/pdf/blocks/medical-intake-form/medical-intake-form";<MedicalIntakeFormDocument
clinicName="Sunrise Family Medicine"
clinicAddress="200 Health Plaza, Denver, CO 80202"
clinicPhone="(303) 555-0180"
accentColor="#0d9488"
/>Sections
Every section is rendered by default and can be hidden by setting its prop to false.
<MedicalIntakeFormDocument
clinicName="Sunrise Family Medicine"
personalInfo
emergencyContact
insurance
medicalHistory
medications
allergies
reasonForVisit
consent
/>| Prop | Section |
|---|---|
personalInfo | Name, date of birth, gender, phone, email, and address fields |
emergencyContact | Contact name, relationship, and phone fields |
insurance | Provider, policy, group, and subscriber fields |
medicalHistory | Condition checklist with allergy and medication prompts |
medications | Medication, dosage, frequency, and prescribing doctor table |
allergies | Allergen, reaction, and severity table |
reasonForVisit | Free-text area for symptoms and reason for the visit |
consent | HIPAA authorization, treatment consent, and signature lines |
Props
| Prop | Type | Description |
|---|---|---|
clinicName | string | Clinic name shown in the header and consent text |
clinicLogo | string | Optional logo image source |
clinicAddress | string | Address shown in the header and footer |
clinicPhone | string | Phone number shown in the header and footer |
accentColor | string | Theme token or CSS color used for section rules and accents |
theme | PdfcnTheme | Theme override for the whole document |