Medical Surveys & Questionnaires
Medical Report Form
A medical report form is a document used by medical professionals for documenting a patient’s medical treatment.
Healthcare FormsScreening Checklist For Visitors And Employees
Prevent the spread of COVID-19 with a free Screening Checklist for Visitors and Employees. Ideal for hospitals or other organizations staying open during the crisis.
Healthcare FormsPatient Feedback Form
A patient feedback form is a survey with questions that allows medical doctors to gather feedback from patients regarding their overall experience with the clinic.
Patient Feedback FormsPatient Medical History Form
The template is used by patients to register medical history through providing their personal information, weight, allergies, illnesses, operations, healthy habits, unhealthy habits. You can integrate the data to your own systems.
Healthcare FormsCoronavirus Case Report Template
People can report suspected cases of COVID-19 in their workplace or community. Easy to customize, integrate, and share online. No coding required.
Healthcare FormsGym Health Questionnaire Form
A gym health questionnaire is a health form that is used by gym instructors to track the health and fitness of their clients.
Healthcare FormsCOVID 19 Vaccine Survey
Get to know how people feel about the new COVID-19 vaccine with a custom online survey. Easy to personalize, embed, and share. Option for HIPAA friendly features.
Healthcare FormsInitial Visit Patient Forms (MDR)
An initial visit patient form is used by medical practitioners to collect information from patients as they arrive at their practice's office for an initial visit.
Healthcare FormsContact Tracing Form
Reduce the spread of coronavirus with a free online Contact Tracing Form. Ideal for hospitals, medical organizations, and nonprofits. Collect data on any device.
Coronavirus Response FormsMedical Questionnaire
Determine if clients are healthy enough to take part in your activity with a free online Medical Questionnaire. Fill in on any device. Sync with 130+ apps.
Healthcare FormsMedical Employment Information Form
Here is an Employee Medical History Form that can be used to create an employee medical information database which provides employee contact information along with emergency contact information and medical insurance details.
Healthcare FormsCounseling Intake Form
The Counseling Intake Form allows for an easier client registration process as it automates gathering information from your clients, reduces paperwork and helps to keep patient records in a systematic way.
Healthcare FormsHealth Evaluation Form
If you have an online health service , this forms is suitable for you. Get your patient history, lifestyle and more. Customize it to your needs
Healthcare FormsHealth Survey
A Health Survey is a form template designed to collect medical information from patients and log their anamnesis
Healthcare FormsPatient Health Questionnaire PHQ9
A Patient Health Questionnaire (PHQ9) is a form template designed to allow hospitals to collect comprehensive information from patients for the purpose of diagnosing and assessing their health.
Healthcare FormsCOVID 19 Questionnaire
Record information about families in need. Free questionnaire for nonprofits. Easy to customize and embed. Integrate with 100+ apps. No coding required.
Questionnaire TemplatesPatient Health Questionnaire
A Patient Health Questionnaire is a form template designed to gather essential information about a patient's personal details, medical history, presenting complaints, family medical history, lifestyle habits, and any additional information relevant to their health.
Healthcare FormsCovid Contact Tracing Form Template
A COVID-19 contact tracing register is used by medical organizations to identify people who have come into contact with a person who is infected with COVID-19, to help prevent the disease from spreading.
Healthcare FormsHIPAA Medical History Form
HIPAA Medical History Form allows gathering patient's contact details with their current symptoms, medications, allergies, drug use, and family medical history that allows for a better healthcare service and management process.
Healthcare FormsBMI Calculator
A BMI Calculator is a form template designed to facilitate the calculation and interpretation of BMI (Body Mass Index), providing valuable information for health management and planning.
Healthcare FormsNutritional Assessment Questionnaire Form
Here is a Nutritional Assessment Questionnaire that is useful for health institutions to learn more about patients' eating habits by asking their blood sugar, fatty acid, inflammation, toxicity, and eating habits.
Healthcare FormsAlternative Medicine Patient Intake Form
Do you work for alternative medicine? This alternative medicine disclaimer form is very useful for those herbal medicine practitioners, wellness practitioners, alternative medicine practitioners, holistic medicine practitioners, etc.
Healthcare FormsVeterinary EMR
Do you work for the veterinary group? This veterinary physical exam template is based on the SOAP template for a veterinary physical exam and evaluation. Veterinary treatment sheet template collects information about client's contact details, appointment time, client pet's details and client physical exam findings.
Veterinary Service FormsPatient Intake Form
Register new patients for your practice with a free online Patient Intake Form. Great for telemedicine or telehealth. Option for HIPAA friendly features.
Healthcare FormsAbout Medical Surveys & Questionnaires
As a medical institution, you might be super confident in your personnel's professional abilities. However, as for any businesses who deals with paying customers, it’s absolutely necessary to get feedback, regarding both medical staff and the institution itself. Jotform’s surveys and questionnaires provide this chance. Since they are completely customizable, you can edit them to match your needs as well.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.