# Web Intake Forms

Web Intake Forms allow you to collect structured postmarketing data such as adverse event reports (AERs) directly from reporters, partners, and field representatives. Respondents can access on desktop and mobile devices and securely submit data without viewing or accessing any areas of your Vault. Vault then generates an _Inbox Item_ from the submitted data.

## Prerequisite

Your Admin must <a href="/en/lr/939319/">enable</a> and <a href="/en/lr/939321/">configure</a> Web Intake Forms.

## How Respondents Access Forms

Respondents access Web Intake Forms using a URL based on your Admin's configuration, which can be provided to respondents directly or accessed on your organization's website depending on your business process. When respondents open the link, they are redirected to a Vault-generated form where they can securely submit data without viewing or accessing any areas of your Vault. 

Veeva Safety provides the following access options for Web Intake Forms:

* _Single Use_ forms with time-limited access for occasional respondents. These can be used for spontaneous adverse event reporting from patients, caregivers, and healthcare personnel.
   1. When a respondent visits the URL for a _Single Use_ form, they must complete a CAPTCHA to proceed with the form.
* _Repeat Use_ forms that require email verification for frequent respondents. These can be used for company field representatives and service providers who submit AERs or are contracted for partner support and market research programs. 
   1. When a respondent visits the URL for a _Repeat Use_ form, they must agree to the Admin-defined privacy notice and enter their email address for verification.
   2. If their email address domain is on the Admin-defined _Allowed Email Domain List_, Vault sends the respondent a _Safety Form Email Verification_ email with a link to verify their email, which is valid for one hour.
   3. When the respondent selects the _Verify my email_ link in the email, they are redirected to a page that confirms their email address has been verified. From that page, they must click on a link to access the form.
   4. Vault then sends a _Safety Form Access_ email to the respondent with a link to the form. The link is valid for one hour. Email verification for a particular form lasts for 30 days, after which a respondent will be prompted to verify their email again before completing the form.

## How Respondents Submit Forms

All Web Intake Forms display your organization's logo based on your Admin's configuration. Navigation steps appear at the top of the form for easy navigation between different sections on the form. Each respondent must agree to your organization's privacy notice, as defined by your Admin, before they can submit their form. Respondents have one hour to complete a form, which begins at the time of form generation. The form page displays messages indicating when a respondent has 30 and 5 minutes remaining to submit their form. A countdown clock appears on the form for their reference. 

When entering data, respondents can:

* Select caret icons to expand (<i class="fas fa-caret-right"></i>) or minimize (<i class="fas fa-caret-down"></i>) each section.
* Navigate between pages for _Product_ and _Event_ sections with multiple entries.
* Add up to 100 products and 100 events. The _Add Product_ and _Add Event_ buttons become active when the respondent has populated all required fields for the current entry.
* For required radio buttons, select _Clear Selection_ to remove the associated response.
* When configured by your Admin, respondents can upload up to five files of up to 10 MB each. Vault includes uploaded files in the _Documents_ section of generated _Inbox Items_. Web Intake Forms support the following file formats:
  * DOC
  * DOCX
  * PDF
  * JPG
  * JPEG
  * XLS
  * XLSX

<a href="https://platform.veevavault.help/assets/images/saf-web-intake-form.png" data-lightbox="saf-web-intake-form.png" data-title="" data-alt="Web Intake Form for AER intake">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-web-intake-form.png" alt="Web Intake Form for AER intake" style="max-width: 60%;"  />
</a>

When respondents enter form data, Vault validates certain fields to ensure the generated _Inbox Item_ contains appropriate values and prevents respondents from proceeding until all values are valid, including:

* _Patient_ section:
  * The _Age at Onset_ cannot exceed 150 years
  * The _Height_ cannot exceed 250 centimeters or 98.425 inches
  * The _Weight_ cannot exceed 650 kilograms or 1433 pounds
  * The _Last Menstrual Period Date_ cannot be more than one day in the future
* _Product_ section:
  * Respondent must add at least one product
  * _Start Date_ cannot be later than _End Date_ or more than one day in the future
* _Event_ section:
  * _Start Date_ cannot be later than _End Date_ or more than one day in the future
  * _Additional Information_ section:
  * _Date of Death_ cannot be before _Start Date_ or _End Date_ for any product or event

### Summary Page

Before submitting a form, respondents can review their responses on the Summary page. On this page, they can:  

* Filter the view to show only completed responses.
* Select caret icons to expand (<img class="inline" src="https://platform.veevavault.help/assets/images/saf-icon-expand.png" alt="Expand Icon" style="" />) or minimize (<img class="inline" src="https://platform.veevavault.help/assets/images/saf-icon-minimize.png" alt="Minimize Icon" style="" />) each section.
* Go back to edit their entries.
* Request an emailed copy of their form.

<a href="https://platform.veevavault.help/assets/images/saf-web-intake-summary.png" data-lightbox="saf-web-intake-summary.png" data-title="" data-alt="Summary page of Web Intake Form for AER intake">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-web-intake-summary.png" alt="Summary page of Web Intake Form for AER intake" style="max-width: 60%;"  />
</a>

#### Confirmation Page

After submission, the Web Intake Form displays a confirmation message and reference number, which matches the _Case Identifier_ value of the generated _Inbox Item_. Respondents can download the completed PDF form on this page.

<a href="https://platform.veevavault.help/assets/images/saf-web-intake-confirmation.png" data-lightbox="saf-web-intake-confirmation.png" data-title="" data-alt="Summary page of Web Intake Form for AER intake">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-web-intake-confirmation.png" alt="Summary page of Web Intake Form for AER intake" style="max-width: 60%;"  />
</a>

## Review Generated Inbox Items {#review}

Upon form submission, Vault generates an _Inbox Item_. You can modify the <a href="/en/lr/01285/">fields</a> as needed and, when applicable, <a href="/en/lr/01141/">promote it to a _Case_</a>. Vault populates fields on generated _Inbox Items_ based on values entered by the respondent on the corresponding fields on the Web Intake Form. Vault also populates the following fields:

* **Intake Method**: _Safety Form_
* **Intake Format**: _Data_
* **New Info Date**: Depending on your Admin's configuration, the date the form was created or the mapped value from the form
* **Source Document**: A PDF of the completed form, classified as _Case > Source > Adverse Event Report_
* **Report Type**: Based on your Admin's configuration.
* **Case Identifier**: Vault-generated reference number, which includes the year and month the form was submitted and an Admin-defined prefix
* **Type**: _Web Intake Form_
* **Documents**: Any documents uploaded on the form, classified as _Case > Source > Non Re-Transmittable Document_
