README

Printable clinic paperwork, with the clinic's own name, address, phone, fax and logo filled in. Each piece can be printed blank to fill in by hand, or with the current patient's details filled in.

Status: 0.38.1, a pre-release. Checked on OpenEMR 7.0.2 to 8.5.0, as an administrator, with synthetic data (see Compatibility). The consents and releases are starting points: have them reviewed for your state before you use them (see The documents are starting points).

It does three things:

Paperwork. Consents, releases, referral letters and office slips, filled from the facility record and, optionally, the open patient and an Address Book entry.
Paper versions of layout forms. Demographics, History, any active encounter form (LBF) and any transaction form (Referral and the like), printed as a blank form with tick boxes, date boxes and ruled lines. With the US pack, a short UDS form prints only the Demographics fields health center reporting reads (sex, gender identity and sexual orientation, race, ethnicity, language, household size and income, housing, agricultural work, military service), with the site's own answer lists. Clinics without a computer in every room can do intake on paper and type it in later, in the same order.
Ready-made packets. New patient intake, annual update, telehealth, referral, after the visit, a procedure visit, a chronic care visit (home logs and a medicine review), an asthma visit, and a downtime kit (in the US pack with the superbill and visit summary). The screening packets are labelled by when they are used:
- every adult, yearly: the yearly adult screen, the short first stage of each screen (PHQ-4 and TAPS-1, and in the US pack the Hunger Vital Sign);
- after a positive screen: depression (the PHQ-9, then the ASQ), anxiety (the GAD-7), PTSD (the PCL-5), substance use (TAPS-1, then TAPS-2) and, in the US pack, food (the six-item survey); and a positive-screen handoff for staff;
- at 65 and over: the older adult add-on (falls and depression), and in the US pack the Medicare Annual Wellness Visit (health risk assessment, PHQ-4, Stay Independent, TAPS-1 and the preventive care questions);
- for adolescents: teen screening (NIDA's BSTAD for tobacco, alcohol and drugs, and the ASQ for suicide risk);
- for a visit about it: depression and anxiety; depression and alcohol; behavioral health, which adds PTSD and substance use; starting a controlled medicine; relationship safety (HARK, given in private); and, in the US pack, pregnancy and postpartum, and a vaccine visit;
- in the US pack: who we serve (the UDS questions and the sliding fee), preventive care, care management enrollment, uninsured or self-pay (the good faith estimate and the sliding fee), Medicare other insurance, notices to post in the office, language help, records from another office, and patient requests (blank forms to stock the front desk).
Each packet opens as one document to print, and says what it is for when you point at its button.
Spanish. Every patient document prints in Spanish too, with the language assistance notices Section 1557 requires (see Spanish and language assistance).
Word and LibreOffice. Any document downloads as a filled Word (.docx) or LibreOffice (.odt) file to edit before printing, and a clinic can write its own letters and forms in Word or LibreOffice and have them filled in (see Word and LibreOffice).
A PDF, and a copy in the chart. The ticked documents download as one PDF, or are saved, filled for the patient, as a PDF in the patient's Documents (see The chart number on every page, and a copy in the chart).

It changes nothing in the database except when staff save a PDF copy to a patient's Documents, which goes through OpenEMR's own document storage. Every page is built when it's opened, from the site's own facility, Address Book and layout settings.

Using it

Miscellaneous › Clinic Forms, just below Blank Forms.

Pick the letterhead (any active facility; the primary business entity comes first), the paper size, and optionally a recipient from the Address Book.
If a patient is open, tick Fill in the current patient to put their name, date of birth, chart ID, address and phone on the pages. Otherwise everything prints blank. Tick Also fill Demographics and History as well to print those forms with what's on file, for a returning patient to check and correct (see Check and correct).
Tick documents and forms, or click a ready-made packet, then Open for printing. The packet opens in a new tab with a Print button.

A packet prints in its own order; anything ticked by hand follows, in the order of the page.

Every printed page starts with a line for the patient's name, date of birth and ID, filled in when a patient is chosen, so a page that comes loose can still be matched to a chart.

The documents

Category	Document	What it is	LOINC	Pack
Front desk	Consent to Treatment	General consent for examination and treatment	59284-0	any
Front desk	Acknowledgment of the Notice of Privacy Practices	Receipt of the Notice, with a clinic-use section for when it wasn't obtained	57016-8	US
Front desk	Financial Policy and Assignment of Benefits	Payment responsibilities, insurance billing and assignment of benefits	59284-0	any
Front desk	Payment Plan Agreement	A balance paid in parts, to HRSA's Compliance Manual chapter 16: open to every pay class, no one refused care for being unable to pay, and the clinic's own steps if payments stop	—	US
Front desk	Authorization to Release Health Information	A HIPAA authorization with the elements 45 CFR 164.508 requires, separate initials for sensitive records, and a 42 CFR Part 2 note	64292-6	US
Front desk	Your Rights and Responsibilities	What patients can expect, and what the clinic asks of them	—	any
Front desk	Missed Appointments	The missed and late appointment policy, with help offered (rides, child care)	—	any
Front desk	Language Help and Interpreter Request	The patient's languages and the help they want, with a staff section for what was arranged	—	any
Front desk	Communication Preferences	How the clinic may contact the patient: phone, voicemail, text, email, portal	59284-0	any
Front desk	Consent for Telehealth Visits	Consent to visits by video or telephone	59284-0	any
Front desk	Consent for Photos and Recordings	Photos, video or audio for the record and care, or for teaching, each ticked separately; publicity needs its own permission	59284-0	any
Front desk	We Offer Discounts Based on Income	A notice to post or hand out: the sliding fee discount, who qualifies, and that no one is turned away; the clinic writes in its own schedule	—	US
Front desk	Sliding Fee Discount Application	Household members and income, proof attached, and a clinic section for the poverty-guideline percentage and discount level (the facts UDS Table 4 reports)	—	US
Screening	Patient Health Questionnaire-4 (PHQ-4)	Two anxiety and two depression questions; each part scored 0 to 6, and 3 or more on either is a positive screen	69724-3	any
Screening	Patient Health Questionnaire (PHQ-2)	The two-question depression screen, scored 0 to 6. The office section notes that it doesn't ask about self-harm	55757-9	any
Screening	Alcohol Use Screen (AUDIT-C)	The WHO AUDIT's first three questions, scored 0 to 12	72109-2	any
Screening	Patient Health Questionnaire (PHQ-9)	Depression screening, scored 0 to 27, with an office prompt to follow the clinic's safety protocol on question 9	44249-1	any
Screening	Generalized Anxiety Disorder Scale (GAD-7)	Anxiety screening, scored 0 to 21	69737-5	any
Screening	PTSD Checklist for DSM-5 (PCL-5)	The VA's 20 questions for a positive PC-PTSD-5, scored 0 to 80; 31 or more suggests probable PTSD	101697-1	any
Screening	Physical Symptoms (PHQ-15)	Fifteen physical symptoms, scored 0 to 30; 5, 10 and 15 mark low, medium and high severity	69728-4	any
Screening	Healthy Days (CDC HRQOL-4)	CDC's four questions on general health and unhealthy days in the past 30		any
Screening	Everyday Discrimination Scale	David Williams's nine questions on unfair treatment in day-to-day life, and its reasons; no cut-off	112307-4	any
Screening	Primary Care PTSD Screen (PC-PTSD-5)	A question about a traumatic event, then five yes or no questions, scored 0 to 5	102010-6	any
Screening	Geriatric Depression Scale, Short Form (GDS-15)	Fifteen yes or no questions for older adults, scored 0 to 15	48543-3	any
Screening	Check Your Risk for Falling (Stay Independent)	CDC's STEADI falls checklist, scored 0 to 14	97874-2	any
Screening	Ask Suicide-Screening Questions (ASQ)	NIMH's suicide risk screen, asked by a nurse or clinician, with NIMH's next steps for each result	115564-7	any
Screening	Hunger Vital Sign™ (Food Insecurity Screen)	Children's HealthWatch's two statements; often or sometimes true to either is a positive screen. Counts on UDS Table 6A line 39 when answered as an OpenEMR questionnaire	88121-9	US
Screening	Food Security Screen (USDA Six-Item)	USDA's six questions on affording food in the last 12 months, scored 0 to 6. Counts on UDS Table 6A line 39 when answered as an OpenEMR questionnaire	95361-2	US
Screening	Substance Use Screen (TAPS-1)	Tobacco, alcohol, drugs and prescription medications not used as prescribed, in the past year; any use is a positive screen for that substance	96841-2	any
Screening	Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD)	NIDA's screen for adolescents: days in the past year of tobacco, alcohol and marijuana, then other drugs and medications for anyone who used any; a risk level for each substance by NIDA's cut-offs		any
Screening	HARK: Relationship Safety Questions	Four yes or no questions about a partner or ex-partner in the past year; 1 or more is a positive screen. Given when the patient is alone	76499-3	any
Screening	Health Risk Assessment (Annual Wellness Visit)	Every topic 42 CFR 410.15 asks a Medicare wellness visit's health risk assessment to address, plus the providers and medicines the first visit lists		US
Front desk	Good Faith Estimate	The No Surprises Act estimate for an uninsured or self-pay patient, with every element of 45 CFR 149.610(c)		US
Front desk	Your Right to a Good Faith Estimate	The notice to post, adapted from CMS's model		US
Front desk	Care Management Services: Consent	What CMS says a patient must be told before chronic care management and related services		US
Front desk	Medicare: Other Insurance Questions	CMS's model questions on whether another payer pays before Medicare, in plainer words		US
Screening	Vaccine Record and Vaccine Information Statements	What the vaccine injury law asks a provider to record for each vaccine, with the information statement given		US
After the visit	Asthma Action Plan	Daily medicines and what to do by green, yellow and red zones, following NHLBI's plan		any
After the visit	Home Blood Pressure Log	Readings at home, with the steps for an accurate reading		any
After the visit	Blood Sugar Log	Two weeks of glucose readings at the times the clinician asks for		any
After the visit	My Medicines: Review	The medicines on file to check and correct, and everything else the patient takes		any
Screening	Preventive Care Questions	The answers the chart doesn't hold that decide which USPSTF A and B screenings are due: pack-years, family history, sexual health, where the patient has lived, pregnancy		US
Screening	Substance Use Assessment (TAPS-2)	For a positive TAPS-1: yes or no questions about each substance in the past 3 months, each substance scored on its own	96845-3	any
Care coordination	Referral Letter	To the Address Book recipient, with urgency, the question to answer, the problems, medicines and allergies on file, and what is enclosed	57133-1	any
Care coordination	Request for Records	A request to another provider for a patient's records	—	any
Office workflow	Patient Routing Slip	Travels with the patient: check-in, rooming, provider, checkout	—	any
Office workflow	Staff Handoff (SBAR)	Handing a patient from one staff member, shift or site to another	—	any
Office workflow	Internal Referral	To behavioral health, care management, nutrition, social work or another of the clinic's sites	57133-1	any
Office workflow	Chaperone Record	Each chaperone offer, the patient's choice, and who was in the room	—	any
Downtime	Encounter Form (Superbill)	One visit's charges on paper: CPT or HCPCS services, ICD-10-CM diagnoses A to L as on the claim form, the billing NPI, sliding fee level, payment	—	US
Downtime	Downtime Visit Note	A paper visit note for when OpenEMR is down, with a box to record when it was entered	11506-3	any
Privacy and patient rights	Notice of Privacy Practices	The notice itself (45 CFR 164.520), with the 42 CFR Part 2 statements required from February 16, 2026; fill in the effective date and privacy contact	57017-6	US
Privacy and patient rights	Request to See or Get a Copy of My Health Record	Right of access (164.524): paper or electronic, to the patient or a person they name	—	US
Privacy and patient rights	Request to Correct My Health Record	Right to amend (164.526)	—	US
Privacy and patient rights	Request for a List of Disclosures	Accounting of disclosures (164.528)	—	US
Privacy and patient rights	Request to Limit How My Information Is Shared	Restrictions (164.522(a)), including self-paid care kept from the health plan	—	US
Privacy and patient rights	Revoking My Authorization to Release Information	Revocation (164.508(b)(5))	—	US
Privacy and patient rights	Consent to Share Substance Use Disorder Treatment Records	42 CFR Part 2 consent with every element of 2.31, including the single consent for treatment, payment and operations	64292-6	US
Privacy and patient rights	Notice of Privacy Practices for Substance Use Disorder Records	The notice 42 CFR 2.22 (2024) requires of a Part 2 program, element by element; fill in the contact and effective date	57017-6	US
Privacy and patient rights	Revoking My Consent to Share Substance Use Disorder Records	Takes back a Part 2 consent, in writing (2.31(a)(6))	—	US
Privacy and patient rights	Personal Representative	Who the law lets act for the patient (power of attorney, guardian, parent, executor), the paper that shows it, and the clinic's check of identity and authority (164.502(g), 164.514(h))	—	US
Privacy and patient rights	Patient Concern or Grievance	A concern or grievance, including unfair treatment, with what 45 CFR 92.8(c) asks the record to hold	—	US
Privacy and patient rights	Notice of Nondiscrimination	The Section 1557 notice (45 CFR 92.10), as a 20-point poster; fill in the Section 1557 Coordinator	—	US
Privacy and patient rights	Free Language Help and Services for People with Disabilities	The Section 1557 notice of availability (92.11) with every tagline, as a 20-point poster	—	US
Privacy and patient rights	Your Family Planning Visit Is Private	The Title X notice to 42 CFR 59: confidentiality, minors, the policyholder's statement, voluntary services, options counseling and charges by income	—	US
Family planning	Title X Family Planning Visit Record	FPAR 2.0's family planning items, each coded as OPA codes it (pregnancy intention, the methods at intake and exit and why none, how provided, counseling), plus Title X's own items from 42 CFR 59	—	US
Privacy and patient rights	You Can Ask for a Chaperone	A poster: a chaperone at any exam, at any time, without a reason	—	any
After the visit	Your Test Results	A results letter: each result and what it means, what to do next, signed by the clinician	—	any
After the visit	Visit Summary and Instructions	What was found, medicines on file and changed today, what to do at home, tests ordered, the next visit	103796-9	any
After the visit	Consent for a Procedure	Informed consent for one procedure: why, benefits, risks, other choices, questions answered	64293-4	any
After the visit	Controlled Medicine Agreement	Patient and clinician agree how a controlled medicine is taken, kept and refilled, and what the clinic will do (taper plans, help with addiction, naloxone)	94136-9	any
After the visit	Work or School Note	Confirms the visit and when the patient may return, without giving the reason for the visit	—	any

The format, and the rules every document follows, are in docs/. Each is a JSON file, the same on every OpenEMR release: in data/documents/ if it applies anywhere, or in data/packs/us/documents/ if it belongs to United States law or programmes (the Pack column; see Country packs). The short UDS form is the US pack's too. The PHQ-9 and GAD-7 are printed with their authors' statement that no permission is needed to reproduce them. Their answers can be typed into OpenEMR's own PHQ-9 and GAD-7 encounter forms, which ship with OpenEMR but have to be enabled under Administration › Forms › Forms Administration.

Standards the documents follow

LOINC document codes where an exact one exists (the table above), as OpenEMR's own C-CDA referral uses 57133-1. Each code is checked by its LOINC check digit; a document with no exact code is left uncoded rather than mislabeled.
What the law says goes in. data/requirements.json (the instruments' wording) and the US pack's data/packs/us/requirements.json list, for the documents a rule governs, each required element and its citation: the Notice of Privacy Practices (164.520(b)(1), element by element), the patient-rights requests (164.522, 164.524, 164.526, 164.528, 164.508(b)(5)), the Part 2 consent (42 CFR 2.31), the HIPAA authorization (45 CFR 164.508(c)), the privacy notice acknowledgment (164.520(c)(2)(ii)), the sliding fee application (HRSA Compliance Manual, chapter 9), the work or school note's minimum necessary (164.502(b)), and the PHQ-9 and GAD-7 wording. The tests fail if a shipped document loses one. A clinic's own version of one of these documents is checked too, and the Clinic Forms page names anything it can't find (by wording, so check before relying on the warning).
Scored as published. A screening score means what its validation study found only when the form is the instrument the study used. data/instruments/ holds a reference for each validated instrument (PHQ-9, PHQ-2, GAD-7, AUDIT-C, PC-PTSD-5, GDS-15, CDC's Stay Independent falls check, the ASQ, TAPS-1 and TAPS-2, the Hunger Vital Sign and USDA's six-item food security screen):
- its questions and answers from LOINC's own questionnaire, and each answer's points from LOINC's answer lists;
- its total range;
- the published cut-offs, each with its paper (PubMed id) or the owner's document, and the sentence that states it;
- or, for a screen read by rule rather than by a total (the ASQ: Yes to any of questions 1 to 4 is a positive screen), its published rules, with their source;
- or, for an instrument scored in parts (TAPS-2 scores each substance), each part's questions and published cut-offs.
The tests fail if a document's questions, their order, its answers, the points for each, its total range or a cut-off it prints differ, if it doesn't say a published rule with the questions it names, or if a translation changes any of them. A difference that is deliberate is listed in the reference with its reason (GAD-7's question 2 and PHQ-9's closing question follow Pfizer's printed form, not LOINC's coding of it). tools/instrument-references.php refreshes the references from LOINC (a free LOINC account) and keeps what was written by hand. tools/loinc-names.php does the same for data/loinc-names.json, LOINC's long common name for every LOINC code the documents and references use, and the tests hold each document's code to that name.

Where the published instrument scores differently from LOINC's answer lists, the reference says so under "scoring", with its source. The tools refuse an instrument whose answers have no score until that is written. LOINC scores PC-PTSD-5's trauma question, which the instrument doesn't; it leaves STEADI's first statement and every GDS-15 answer unscored. It has TAPS-1's prescription question as free text with no answers, and lists another question's answers backwards: a reference can give a question another's answers and put them in the published order. LOINC's six-item food security questionnaire leaves out one of the six questions, so that reference is written from USDA's own module, with LOINC's codes, and says so. tools/import-instrument.php brings a new instrument in from LOINC: its reference, and a draft document to compare with the instrument's printed form before it is made active.

A clinic's own version of one of these instruments is checked the same way. That means its own file with the instrument's id, or its own document marked validated with a LOINC code there is a reference for. The Clinic Forms page names each question, answer or point that differs, because a score from a changed form may not mean what the published cut-offs say. The PHQ-9 and GAD-7 print their published severity bands in the office-use section, and the check holds those numbers to the papers.
Plain language. Every patient document reads at an 8th-grade level or below (Flesch-Kincaid), as AHRQ's health literacy toolkit advises; the tests measure it. Validated instruments (PHQ-9, GAD-7) keep their published wording and are exempt.
Each document says who reads it (patient, staff or provider) and whether its wording is a validated instrument's.
Each document has a version, printed small at the foot of every page with its id (consent-to-treat v1) and recorded in the audit event, so a signed copy names the wording the patient signed. A version means one wording: the tests fail if a document's wording changes without its version being raised.
Each document says where its wording comes from and on what terms: written for Clinic Forms, written to a rule's elements (with a link to the rule), or a published instrument (with its holder, terms and the permission they give: PHQ-9, PHQ-4, PHQ-2, PHQ-15 and GAD-7 from Pfizer, "no permission required"; AUDIT-C from the WHO manual; the Hunger Vital Sign from Children's HealthWatch, free with its citation; PC-PTSD-5 from the VA, the ASQ from NIMH, TAPS-1 from NIDA, Stay Independent from CDC and the GDS-15 from its developers, all public domain; documents written for Clinic Forms, CC0).

The documents are starting points

They are written to be plain and complete, not as legal advice. Consent, release and financial wording varies by state and by payer, and some states have their own required forms (minors' consent, mental health, HIV testing). Read them with whoever reviews your clinic's forms before using them, and replace any of them with your own (see the next section).

Country packs

The documents that work anywhere (consent to treatment, the screening questionnaires, letters, office slips) are the core. A country pack adds the documents of one country's law and programmes, and can replace a core document with its own version. Clinic Forms ships one pack, the United States: the HIPAA privacy set, 42 CFR Part 2, the Section 1557 notices and taglines, the HRSA sliding fee documents and the UDS form, with their legal checks and the packets that use them.

Which pack. settings.json in your Clinic Forms folder (below) says {"country": "us"}, or {"country": "none"} for the core alone. Without it, the country typed for your first facility under Administration › Facilities decides: blank (as a default install leaves it) or a US spelling (US, USA, United States) means the US pack. Another country gets the core alone and a note on the page.
Regions. The facility's State picks its region. For now that drives the tagline check: the page lists, for each facility's state, which of the 15 languages the Census counts there have no tagline yet (Census groups such as "Amharic, Somali, or other Afro-Asiatic languages" are named for you to check against HHS's list). A region can also carry documents of its own (data/packs/us/regions/<code>/documents/); none ship yet.
Order. Core, then the pack, then the region, then your own folder: each replaces the one before with the same id. A translation made for the replaced version is out of date, and prints in English.
Paper. The pack says the paper the picker starts on (Letter for the US; A4 without a pack).
Another country. A pack is a folder in data/packs/<two-letter code>/ with pack.json (name, the facility country names that choose it, paper, layout forms), documents/, and optionally requirements.json, packets.json, taglines.json and regions.json. The format is in src/Paper/Pack.php.

Your own documents

Put your own documents in sites/<site>/documents/clinic-forms/ (for most installs, sites/default/documents/clinic-forms/), in the same format as data/documents/. That folder belongs to the site, so module updates leave it alone.

A file with a new id adds a document. A file with the id of a shipped document replaces it, so the clinic's edited consent prints instead of the module's.
Know when the module's version changes. Start from a copy of the shipped file and add the "based_on" line the Clinic Forms page shows for it. When a later module release changes that document, the page says so and names the file to compare with. Your version keeps printing; it is never overwritten.
Stop offering a shipped document without replacing it: list its id in settings.json, {"hide": ["financial-policy"]}. It leaves the picker and the packets.
A document marked "status": "draft" is offered with a Draft badge and prints "draft" at the foot of each page; "retired" stops offering it.
Files are checked strictly. A document with an unknown field, an unknown block type or a placeholder that doesn't exist is left out, and the Clinic Forms page names the file and the mistake.
settings.json in the same folder chooses the country pack and hides shipped documents: {"country": "us", "hide": ["financial-policy"]} (both optional).
Your own packets go in packets.json in the same folder, in the format of data/packets.json: an id, a title, the items and, optionally, an about line saying what the packet is for. A packet with the id of a shipped one replaces it. A file with a mistake is left out and reported; the shipped packets stay.

The format is in src/Paper/Document.php. Blocks are headings, paragraphs, fields, checklists, ruled lines, signature lines, scales (a question per row and a box per answer, optionally scored, as the PHQ-9 is) and tables (column headings over blank rows, as the household list is). Text can use these placeholders, which print as a blank line when the value isn't known:

Group	Placeholders
`facility`	`{facility.name}` `{facility.address}` `{facility.phone}` `{facility.fax}` `{facility.email}` `{facility.website}` `{facility.npi}`
`patient`	`{patient.name}` `{patient.dob}` `{patient.id}` `{patient.address}` `{patient.street}` `{patient.city}` `{patient.state}` `{patient.zip}` `{patient.phone}` `{patient.sex}` `{patient.allergies}` `{patient.medications}` `{patient.problems}` (current allergies, medications and problems, as OpenEMR's issue lists hold them)
`recipient`	`{recipient.name}` `{recipient.organization}` `{recipient.specialty}` `{recipient.address}` `{recipient.phone}` `{recipient.fax}` `{recipient.email}`
`user`	`{user.name}` (the person printing)
`provider`	`{provider.name}` `{provider.credentials}` `{provider.npi}` `{provider.specialty}`: the Signing provider chosen at the top of the page. It defaults to the clinician printing, or else the patient's own provider. Credentials are the user's Valedictory (MD, NP) under Administration › Users
`clinic`	`{clinic.today}`

What each document is held to

CONFORMANCE.md, generated from the documents and kept current by CI, lists each document, what it follows and how that's checked. A document written to a rule is held to that rule's elements (data/requirements.json and the US pack's), and a validated instrument to LOINC's reference. Any other published instrument is held to its publisher's wording, kept in data/references. The tests fail on any document that isn't.

A document not yet cleared for public release is held back, with its reason, in data/release-gates.json. It ships as a draft, marked Draft in the picker and on every printed page, and no packet offers it. A document whose answers carry SNOMED CT US Extension codes is held automatically, because those codes' licence doesn't cover a public, worldwide download.

Checked outside the module, in the openhealthcare workspace: every FHIR export against FHIR R4 and SDC 4.0.0 (the HL7 validator, nightly), skip logic and totals in OpenEMR's own questionnaire runtime (nightly), and every patient document against PDF/UA-1 by all three routes (veraPDF, weekly).

Spanish and language assistance

Choose Español as the language at the top of the Clinic Forms page. Documents marked ES print in Spanish; staff documents and the rest stay in English. The words Clinic Forms prints itself (Phone, Date, the patient line) follow the paper's language, not the language you use OpenEMR in. Word and LibreOffice downloads follow it too.

22 of the 58 patient documents have Spanish versions, in the es/ folder beside each (data/documents/es/, data/packs/us/documents/es/). The others print in English until the next language update.
The validated questionnaires use their official Spanish wording. PHQ-9, PHQ-2 and GAD-7 are the "Spanish for the USA" versions from phqscreeners.com. AUDIT-C is from the WHO's Spanish AUDIT manual. The ASQ (asked by staff) uses NIMH's Spanish translation for its questions and the steps that translation has; what NIMH added in its 2025 revision is translated by Clinic Forms, and the page says so.
The other translations are ours. Have a qualified translator review them before use, as you would the English.
Nothing gets dropped in translation. Each translation is checked against its English document: the same blocks, fields, items, signature lines and placeholders. The key legal wording is checked in Spanish too.
Old Spanish is never printed for new English. Each translation records which English wording it was made from (its translates fingerprint). When the English changes, through a module update or your own version of the document, the document prints in English and the page lists it as out of date until its Spanish is updated. The picker marks it ES out of date.
Your own translations: put them in sites/<site>/documents/clinic-forms/es/, with the English document's id. The page warns if one doesn't match its English document. If you start from a shipped Spanish file, keep its translates line: then your copy, too, is marked out of date when its English changes. A translation without that line is printed without this check.
Layout forms (Demographics, History) still print with your site's labels. OpenEMR's own Spanish translation renders "Ethnicity" as "Raza", which means race, so it isn't used for intake forms.

Section 1557 language assistance (45 CFR 92.10 and 92.11).

Taglines on every patient page. With Add the language assistance taglines ticked (the default), every patient document and intake form ends with short notices, in English and Spanish, saying that free language help and disability aids are available. They come first in the paper's own language. The rule asks for them on the notice of privacy practices, intake and consent forms, billing communications and complaint forms.
Your state's languages. The rule asks for English and at least the 15 languages most spoken by people with limited English in your state. Clinic Forms ships English and Spanish, and the page lists the languages your facilities' states still need (from the Census Bureau's 2019–2023 American Community Survey; HHS's own list is the one the rule uses). Add the others, with HHS's translations, in sites/<site>/documents/clinic-forms/taglines.json:
```
{"taglines": {"vi": "CHÚ Ý: … Gọi số {facility.phone} (TTY: 711).", "zh-Hant": "注意：… {facility.phone} (TTY: 711)。"}}
```
The two notices print as posters in 20-point sans serif, as the rule requires for posting:
- the Notice of Nondiscrimination;
- Free Language Help and Services for People with Disabilities, the notice of availability, which lists every tagline.
A poster never carries the patient line.

Word and LibreOffice

Edit before printing. Tick documents and click Word (.docx) or LibreOffice (.odt) instead of Open for printing. You get one file with the same letterhead, recipient and patient details the printed packet would have, to change before printing: a referral letter's wording, a note's restrictions. It opens in Word, LibreOffice and Google Docs, and every page carries the patient line in its header. Layout forms (Demographics and the like) print from the browser only.

An accessible PDF. When LibreOffice is installed on the OpenEMR server, every PDF Clinic Forms makes (the PDF download and the copy saved to the chart) is made by LibreOffice from the module's own LibreOffice file, with PDF/UA on: tagged for a screen reader, with its documents' title and language and its fonts embedded, the patient line at the top of every page and the chart number's barcode at the foot. Clinic Forms looks for LibreOffice only where LibreOffice installs itself (/usr/bin/soffice and the others in LibreOfficePdf::PLACES), never at a path from a setting or a request. On OpenEMR's official Docker image, apk add libreoffice-writer installs it (about 1 GB with what it needs). "pdf_libreoffice": false in settings.json turns it off. Without LibreOffice, the PDF is made by the mPDF OpenEMR ships, which writes no tags, so it doesn't meet PDF/UA, the standard for accessible PDFs. For blank documents, Accessible PDF, blank then gives the PDFs made when Clinic Forms was released, each checked with veraPDF's PDF/UA-1 check: US Letter, with the language assistance taglines, and no letterhead, since the clinic isn't known when they're made (US pack; several come in a .zip). One is given only while the document's wording and the taglines are the ones it was made from, so a clinic's own version gets none. For a filled document without LibreOffice on the server, download the Word or LibreOffice file and, in LibreOffice, use File › Export as PDF with Universal Accessibility (PDF/UA) ticked. The HHS Section 504 rule asks health centers for accessible electronic documents (WCAG 2.1 AA) from 2027-05-11, or 2028-05-10 with fewer than 15 employees.

Fill on screen (FHIR Questionnaire). Tick documents and click FHIR Questionnaire (.json) to download them as FHIR R4 Questionnaires: one file, or a Bundle when several are ticked. They are blank forms with the clinic's details and never a patient's (a field the chart fills, such as the patient's name, is left out, since a response names its patient), so no audit event is written. Use them in another system that fills FHIR Questionnaires, or add them straight to OpenEMR's own questionnaires, as described next.

The validated instruments carry LOINC's question and answer codes, with the answers in the published order and each answer's points. Their total line adds the points up as the questions are answered, in OpenEMR's own questionnaire runtime (OpenEMR 8.3 and later). Each coded total is marked for SDC extraction, so a form filler that extracts makes it an Observation with LOINC's code (OpenEMR doesn't extract yet).
Questions asked only after a certain answer appear only then: ASQ's acuity question after a Yes to any of 1 to 4, and BSTAD's other drugs after any days of use. Checked in OpenEMR's runtime on 8.3, 8.4.1 and 8.5 (in development). The paper keeps its written instructions. A clinic's own documents can do the same: see docs/DOCUMENT-FORMAT.md.
Every LOINC code goes with LOINC's own name for it, as the LOINC licence asks of LOINC content passed on:
- a document's, question's or total's code with its long common name, from data/loinc-names.json;
- an answer's code with LOINC's answer text. Where that differs from the paper form, the screen shows LOINC's: AUDIT-C's "2-4 times a month" for WHO's "2 to 4 times a month". The printed form keeps the paper's wording.
A Spanish questionnaire, when it keeps its English instrument, has the same question codes and points. Its answers are the instrument owner's Spanish, not LOINC's wording, so they are coded in the module's own system, by position, and still add up to the same total. A clinic's own version that differs from its instrument carries no codes.
Every shipped document and translation passes:
- the HL7 FHIR validator, against the SDC 4.0.0 questionnaire profile each Questionnaire claims. It notes five things that are expected: SDC's preference for semantic versions, where Clinic Forms numbers its versions 1, 2, 3; a Spanish questionnaire's codes carrying LOINC's English names where LOINC has no Spanish one; the ASQ's codes, and LOINC 2.83's new names for the food security survey's, being newer than the terminology server's LOINC (2.82); and LOINC's questionnaires not being fetchable;
- OpenEMR 8.4.1's questionnaire import check;
- OpenEMR's questionnaire runtime, which works out each instrument's total correctly.

Enter paper answers in OpenEMR (Add to OpenEMR questionnaires). Tick documents and click Add to OpenEMR questionnaires to add them to OpenEMR's own questionnaires, as the same blank Questionnaires. Staff then enter a patient's answers from the paper form in OpenEMR: in an encounter, Questionnaires, then New Questionnaire, or, on OpenEMR 8.3 and later, the patient menu, Assessments, then Questionnaires. OpenEMR adds up the score as the answers go in, and keeps the answers in the chart as a FHIR QuestionnaireResponse, with LOINC's codes for the validated instruments.

The button is shown to users with OpenEMR's Admin > Forms permission (admin / forms), the permission OpenEMR asks for before importing forms. It adds a questionnaire for everyone at the site.
OpenEMR files questionnaires by title. Adding a document again updates the questionnaire it added before, in place, and OpenEMR raises its version.
OpenEMR 8.5 (in development) decides where each questionnaire is offered. A newly added one is offered on the patient dashboard, and Questionnaire Availability, on the patient's Questionnaires page, changes where it appears. Adding it again leaves those choices as they are. Questionnaires added before a site upgrades to 8.5 keep appearing where they did. Checked against OpenEMR master a10ebfa8d3 (2026-10-22).
- A packet only at certain visit types, such as the yearly adult screen at annual visits, is set up in OpenEMR itself, as its author describes it (openemr/openemr#14485):
  1. Register each questionnaire as an encounter form. That shows it at every visit.
  2. In Questionnaire Availability, add one rule per questionnaire and visit category. Rules add up, so one questionnaire can belong to several visit types.
  3. Switch off the every-visit rule and keep the visit-category ones.
  Clinic Forms doesn't do this for you. OpenEMR has no service for registering an encounter form, and Clinic Forms writes to the database only through OpenEMR's own services.
A questionnaire with the same title that Clinic Forms didn't add (one the clinic imported itself, say) is left as it is, and so is one the clinic has turned off. The page says which.
A document with nothing to answer, such as the notice of free language help, is left out.
Each one is filed under Survey, the category OpenEMR's encounter form gives its own questionnaires (OpenEMR 8.0 and later; 7.0 has no categories).
An audit event names each document, its version and the questionnaire's number in OpenEMR.
Checked on OpenEMR 8.4.1 in a headless browser: the PHQ-9, added, is filled in OpenEMR's own Questionnaires page with the highest-scoring answers. The page shows 27, and the saved response holds the coded answers and the total. On 7.0.3 it is added and offered by the encounter form; OpenEMR works out totals in 8.3 and later.

For OpenMRS. tools/export-o3.php writes each validated instrument that CIEL, the concept dictionary most OpenMRS sites load, can carry as an OpenMRS 3 form, for the O3 Form Builder. Its questions and answers are saved as CIEL concepts (data/ciel.json, from CIEL's latest release). Today that is the PHQ-9, PHQ-2 and GAD-7, in English and Spanish; PHQ-9's unscored closing question, which CIEL lacks, is left out and named in the form. CIEL has no concepts yet for the other instruments' questions (AUDIT-C, PC-PTSD-5, GDS-15, the ASQ, TAPS-1, Stay Independent and USDA's food security screen), so they have no OpenMRS form; their FHIR Questionnaires carry LOINC's codes. The forms pass OpenMRS's published form schema, and each concept and answer is checked against the CIEL release.

Your own documents, written in Word or LibreOffice. Write a letter or form as you normally would, type placeholders where details belong, and an administrator adds it under Add your own Word or LibreOffice documents at the foot of the Clinic Forms page. It then appears under Your Word and LibreOffice documents, and staff download it filled with the letterhead, recipient and patient chosen at the top of the page.

Placeholders are the ones in the table above ({recipient.name}, {patient.medications}, {user.name}…). The tags OpenEMR's own Document Templates use for the same facts also work ({PatientName}, {PatientDOB}, {Address}, {Medications}…), so an existing template can be added as it is. The page lists every placeholder and its OpenEMR equivalent.
Formatting is kept. Word and LibreOffice often store a typed placeholder in pieces (after an edit, a spelling check, a change of font); those are found and filled too. Placeholders in the body, tables, text boxes, headers and footers are filled.
When it's added, the page lists the placeholders the document uses, and names any that Clinic Forms won't fill (a typo, or an OpenEMR tag such as {DOS}), which are left as typed.
Only real Word or LibreOffice files of up to 5 MB are accepted. They're kept in sites/<site>/documents/clinic-forms/, so module updates leave them alone; adding a file with the same name replaces it.
Nothing is stored when a filled document is downloaded: it's built and sent.

OpenEMR's Document Templates (Administration › Documents) remain as they are. These add the clinic letterhead, an Address Book recipient and the person printing, which those templates can't fill, and keep & as & (OpenEMR's templates print it as "[and]").

Paper versions of layout forms

Each group of the layout becomes a heading, and each field in use a labelled blank shaped for its type:

lists, checkboxes and radio buttons print their options as tick boxes, marked "tick one" or "tick all that apply";
a list of more than 24 options (language, country, religion) prints the options this clinic's patients actually have, up to 12, most used first, and an Other line. Only counts are read, never a patient's answer. A clinic with no patients yet gets a line to write on;
exam results, textbox lists and checkboxes with text print a row per option, as OpenEMR's own blank forms do;
lifestyle fields print Current / Quit (with a date) / Never / N/A;
dates print as day, month and year boxes, text areas as ruled lines, signatures as a signature line;
fields that pick a record (a provider, pharmacy, facility, code or insurance) print as a line.

Short answers sit two to a row. Labels and list options follow the site's translation settings, as the screens do. A field with no label on screen (middle and last name share the "Name" row) is labelled with its description.

On Demographics, the fields the clinic fills rather than the patient (chart number, providers, portal login, registry and publicity codes, deceased date and others: the list is LayoutPaper::OFFICE_FIELDS) print last, in a For office use box. Each one names the screen tab it's typed into (Who, Choices, Stats…), since the box gathers fields from several.

The paper follows the entry screens. Fields print in the order the Edit Demographics, New Patient and Edit History screens show them (and the Tab key moves through them). Measured on 8.4.1 with dev/clinic_forms_entry_order.py in the openhealthcare workspace: 107 Demographics fields, 15 on the UDS form and 35 on History. The only step back is the start of the office box, which then goes forward tab by tab. Fields with the same position number are ordered as the screens order them.

Check and correct

For a returning patient, Demographics and History can print filled with what's on file instead of blank. The patient crosses out what's wrong, writes the correction beside it, and fills in what's missing, so staff type in only the changes.

Text and dates are written on their lines. The options on file are ticked (X), including a long list's answer even when it isn't among the clinic's common options. Lifestyle status, quit dates and notes are filled. Exam results and the other row-per-option fields are filled row by row.
Providers, the pharmacy, address book entries and facilities print by name.
Social Security and driver license numbers print as their last four characters only.
History prints the patient's latest History record. Encounter and transaction forms have no single record to read, so they print blank.
The audit event for the print says which forms were filled from the chart.

The form prints whatever the site's layout has in use, so a long layout makes a long form. To shorten it, hide fields under Administration › Forms › Layouts.

The chart number on every page, and a copy in the chart

A barcode at the foot of every page. Printed with a patient, each page carries the patient's chart number (the "External ID", pubpid) as a Code 128 barcode, beside the document's id and version. OpenEMR's own patient barcode labels encode the same number. A scanned page can then be filed to the right chart by its barcode, and a loose page still says whose it is. Blank prints and posters carry none.
A box for a patient label. For clinics that stick patient labels on paper, "label_box": true in settings.json prints a box the size of a standard label (2⅝ by 1 inch) at the top of each blank document's first page.
A copy in the chart. With a patient chosen, Save a PDF copy in the patient chart files the ticked documents, filled for that patient, as one PDF in their Documents, under Medical Record (or the category named by "documents_category" in settings.json). It goes through OpenEMR's own Document class, as the Patient Portal's PDFs do, so it's stored and encrypted like any other document. The audit log records it with each document's version.
- PDF downloads the same file without saving it.
- Both are made by LibreOffice when the server has it (see An accessible PDF), and otherwise by the mPDF OpenEMR ships; the buttons are hidden where there's neither.
- mPDF's PDF carries the patient line and the document's title at the top of every page, and its version and the barcode at the foot, as the printed page does. LibreOffice's carries the patient line at the top of every page and the barcode at the foot, and each document's version at its end, as the Word and LibreOffice files do. If LibreOffice fails, or takes over a minute, mPDF makes the PDF.

Printing

Printing is the browser's own: no print server and nothing to install. When Administration › Config › Logging › Printing Log Option is on, the Print button goes through OpenEMR's print logging, like the rest of OpenEMR.

Install

composer require anun333/oe-module-clinic-forms

Run it in the OpenEMR directory. It installs into interface/modules/custom_modules/oe-module-clinic-forms/. Then, under Modules › Manage Modules, register, install and enable Clinic Forms. There is no install SQL. It brings openhealthcare-common, the small library of OpenEMR compatibility code the openhealthcare modules share; Composer installs it alongside.

Access

As written in the code, not verified for restricted users:

The menu entry, the page, printing and downloading need Patients › Demographics (patients/demo), view.
Adding and removing your own Word and LibreOffice documents needs Administration › Superuser (admin/super).
Saving a PDF copy in a patient's chart needs Patients › Documents (patients/docs), write or add-only, as uploading a document does.
Printing, downloading and adding accept only a form posted from the Clinic Forms page (CSRF token).
Printing or downloading with a patient's details filled in writes a patient-record-select event to OpenEMR's audit log, naming the patient and the documents. Blank printing writes nothing. Adding or removing a document writes an other event. Saving a PDF copy to Documents writes a patient-record-insert event naming the file, the document's id, its category and each document's version.

FOOTPRINT.md, generated from the source, lists everything it reads, the OpenEMR functions it calls and what it hooks.

Compatibility

PHP security. PHP's php2shell advisory (2026-10-21; CVE-2026-109618 and CVE-2026-109619) is remote code execution without logging in, and it is being exploited. Run OpenEMR on PHP 8.2.35, 8.3.36, 8.4.27, 8.5.12 or later, whatever the module needs. The official OpenEMR 7.0.2 and 7.0.3 Docker images can't get that fix: they carry PHP 8.2.16 and 8.3.15 on Alpine releases that no longer get updates. Run 7.0 only on a patched PHP, or upgrade OpenEMR. OpenEMR rebuilt its 8.4.1, 8.3.0, 8.2.0 and 8.0.0.3 images with the fix on 2026-10-22 (forum t/27157); a container started before then needs pulling again.

OpenEMR	Checked	How
7.0.2, 7.0.3, 8.1.0, 8.3.0, 8.5.0	2026-10-23	Official images, fresh install, with every module enabled and with it alone, on openhealthcare-common: installed through Module Manager; the picker, the print page (75 of 75 pages), a Word and a PDF export, added to OpenEMR questionnaires, saved to Documents, and the FHIR export, with no failing page.
8.4.1	2026-10-15	Installed through Module Manager. The picker and a packet of every document, Demographics, History and Referral printed with no PHP errors, blank and filled, and printed to PDF in Chromium to check the pages. A print without the CSRF token is refused. Local documents, valid and broken, tested.
7.0.2, 7.0.3	2026-10-16	Official images, fresh install: installed through Module Manager; the picker, a 32-page blank packet and a Word export, with no PHP error. On 7.0.3 also: the menu entry, a print without the CSRF token refused (403), and a Spanish packet filled from the chart with its audit event.
8.1.0, 8.2.0, 8.3.0, 8.4.0, 8.5.0	2026-10-15	Official images, fresh install: installed through Module Manager; the picker loads and a blank packet of all 12 documents, Demographics, History and Referral prints all 15 pages with no PHP error.

0.1.1 was checked again on 8.1.0 and 8.5.0 the same way, and end to end on 8.4.1: layout titles, the patient line on every page, long lists against the clinic's own counts (Demographics and a synthetic encounter form, a deleted form left out, option ids in any case), clinic documents and packets valid and broken, the CSRF refusal, and one audit event for a filled print and none for a blank one.

0.9.0 runs on OpenEMR 7.0 as well. The few OpenEMR calls that changed between 7.0 and 8.x go through one small adapter (src/Compat/OpenEmr.php), which uses the newer call where it exists and the 7.0 way otherwise. Checked on the official 7.0.2, 7.0.3, 8.1.0 and 8.5.0 images, and on 7.0.3 in depth: the menu entry, a refused print without the CSRF token, and a Spanish packet filled from the chart with its audit event.

It needs PHP 8.2 or later (OpenEMR's 7.0.3 image runs 8.3) and PHP's zip and DOM extensions. OpenEMR 6.x and older aren't supported: their images run PHP 8.0.

Development

composer install
vendor/bin/phpunit
php tools/footprint.php --check

The tests need no database: they cover the document library (every shipped document loads and renders blank and filled with no placeholder left), the escaping, the packets and the paper version of each field type.

Known limitations

Only Demographics and History can be filled from the chart; encounter and transaction forms print blank. Previous names, additional addresses and related persons (kept in their own tables) print blank.
The United States is the only country pack; elsewhere Clinic Forms offers the core documents, and a clinic adds its country's own. The pack is per site, so facilities in two countries share one (their states still each get their own region).
Spanish is the only translation. The reading-level check measures the English only (its formula is for English). Layout forms print with the site's labels in either language.
Word and LibreOffice downloads of posters use the normal type size; print posters from the browser.
Adding your own documents and packets means writing JSON files on the server.
Nothing is faxed or emailed. Scanned pages aren't filed automatically: the barcode is there for a scanning workflow, not read by the module.
Word, LibreOffice and PDF files use plain tick boxes (☐) and no logo, and layout forms aren't included.
A document filed without a name (the grievance form, "anonymous": true) never prints the patient's details, patient line or barcode. A Word or LibreOffice file has one page header for the whole file, so when a grievance form is among its documents the header's patient line is left blank, and the other documents are still filled in (from 0.38.0; before, the header named the patient). A PDF with one is made by mPDF, which gives each document its own header. Placeholders in footnotes and comments of your own documents aren't filled.
Questionnaires and Patient Portal document templates don't print from here.

Other modules for OpenEMR

From the same project. Each installs with composer require anun333/<module> and is then enabled in Modules › Manage Modules.

Module	What it does
UDS Report	HRSA's Uniform Data System report for health centers: the patient, visit and diagnosis tables, eCQM readiness, a Table 9D worksheet and grant evidence
Staff Worklist	One queue of outstanding staff work: unsigned results, orders with no result, referrals with no reply, screening and claims follow-up
Sliding Fee Discount	HRSA's sliding fee discount program: the schedule checked against Chapter 9, income assessments, and the discount applied
Care Management	CCM, PCM and BHI enrollment with CMS's consent elements, monthly time logging, and the codes each month meets
Migration	Records from another EHR, read from the FHIR export certified EHRs offer, checked before import and safe to rerun
Layout Export	Layouts and lists exported to files you can keep in version control, compared with the site or another file; reads the old Backup page's SQL files without running them

License

The code (src/, public/, tools/, tests/ and the module's wiring) is GPL-3.0-or-later, as OpenEMR is. See LICENSE.
The documents written for Clinic Forms, their translations, the packets and the lists of required elements (data/) are dedicated to the public domain under CC0 1.0 (LICENSES/CC0-1.0.txt). They are forms to adapt and print: use them, change them and share them with no credit needed. Each document's own "licence" says which terms it is under.
Except what other people own, which keeps its owners' terms. Each document names its holder and terms:
- the screening instruments: PHQ-9, PHQ-4, PHQ-2, PHQ-15 and GAD-7 from Pfizer ("no permission required to reproduce, translate, display or distribute"); AUDIT-C from the WHO manual (not for sale); the Hunger Vital Sign™ from Children's HealthWatch (no fee or license, with its citation; the name is their trademark); HARK under CC BY 2.0 from its authors' open-access article (Sohal, Eldridge and Feder 2007), with that citation and licence on the page; the Everyday Discrimination Scale from David Williams (publicly available, no permission needed); the rest free to use: the VA's PC-PTSD-5 and PCL-5, CDC's Healthy Days, NIMH's ASQ, NIDA's TAPS and USDA's food security survey (US government works); NIDA's BSTAD, included unchanged with its citation (Kelly et al. 2014) by NIH's permission (Ask NIH, 2026-10-19); CDC's Stay Independent, which the Greater Los Angeles VA Geriatric Research Education Clinical Center developed (Rubenstein et al. 2011) and CDC adapted with the authors' permission, a credit it keeps on the page; and the GDS-15, which its developers placed in the public domain;
- LOINC's codes, names and questionnaires in data/instruments/, under the LOINC licence (Regenstrief Institute);
  
  This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
- the CIEL concept numbers in data/ciel.json, under CC BY 4.0 (Columbia International eHealth Laboratory, via Open Concept Lab).

anun333 / oe-module-clinic-forms

Package info

Security

Statistics