Healthcare Forms

1,727 Templates

Registering new patients or learning about previous medical history are some of the processes made easier with our collection of online healthcare form templates. Our form builder provides Healthcare practitioners with an array of widgets, applications, and themes to enhance patient engagement. Enabling better communication between patient and provider, to better understand patients and their needs.

Get started by choosing one of our healthcare templates or start your customizing your own form. Additionally, Jotform offers the simple way to update medical history, acquire consent signatures, collect bill payments, find new business, and more. Plus, Jotform offers HIPAA compliant forms, so your paper healthcare forms are secure.

View our full collection of online healthcare form templates below.

COVID 19 Vaccine Registration Form

COVID 19 Vaccine Registration Form

Collect COVID-19 vaccine registrations online. Fill out on any device. Easy to customize, share, and embed. Convert submissions to PDFs instantly. HIPAA option.

COVID 19 Vaccine Consent Form

COVID 19 Vaccine Consent Form

Collect signed COVID-19 vaccine consent forms online. Easy to customize, share, and fill out on any device. Upgrade for HIPAA compliance. Convert to PDFs instantly.

COVID 19 Vaccine Survey

COVID 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 compliance.

COVID 19 Vaccine Declination Form

COVID 19 Vaccine Declination Form

Document the person's refusal from receiving the COVID-19 vaccination. Copy this COVID-19 Vaccination Declination Form to your Jotform account.

COVID 19 Vaccine Appointment Form

COVID 19 Vaccine Appointment Form

A COVID-19 vaccine appointment form is used by medical practices to schedule COVID-19 vaccine appointments. It’s been a long time coming, and patients are anxious to get their vaccines administered as quickly as possible — so make the scheduling process as seamless as possible with Jotform’s free online COVID-19 Vaccine Appointment Form. Just customize the form to match your practice, opt for HIPAA compliance to keep patient data secure, embed the form in your website or share it with a link, and start collecting bookings online. Use Jotform’s drag-and-drop Form Builder to quickly add your appointment slots to the calendar widget, which automatically makes bookings unavailable once they have been booked by a previous patient — a great way to avoid double-booking! You can also upload your logo, include extra questions, and further personalize the design — or sync submissions to third-party apps like Google Calendar, Google Sheets, and Slack with our 100+ free form integrations! Improve the way you book appointments for your practice with Jotform’s online COVID-19 Vaccine Appointment Form.

COVID 19 Vaccine Pre Registration Form

COVID 19 Vaccine Pre Registration Form

Pre-register your patients for them to receive a COVID-19 vaccine. Copy this COVID-19 Vaccine Pre-registration Form template to your Jotform account.

COVID Vaccine Consent Form Updated CPESN

COVID Vaccine Consent Form Updated CPESN

COVID-19 Vaccine Consent Form for CPESN Pharmacies to get online appointments, collect patient data and consent to vaccination terms and conditions.

Moderna COVID 19 Vaccine Appointment Scheduling And Consent Form CPESN

Moderna COVID 19 Vaccine Appointment Scheduling And Consent Form CPESN

This vaccine appointment form is for the use of CPESN facilities to collect online vaccination appointments for the Moderna Vaccine by asking their patients to provide their personal and contact information, current health status and insurance information, vaccine details and consent to each term and condition through e-signature.

COVID 19 Vaccine Pre Screening Form

COVID 19 Vaccine Pre Screening Form

The COVID-19 Vaccine Pre-screening Form is used by medical practitioners and pharmacists to screen potential COVID-19 vaccine recipients to determine whether there is any reason the patient should not receive the COVID-19 vaccine. Once screened, the individuals may be sent for further evaluation if they do not meet the necessary conditions.

Pharmacy Service Satisfaction Survey

Pharmacy Service Satisfaction Survey

Are they satisfied with your service? Want to find out? Make use of our template to help yourself up!

COVID 19 Liability Waiver

COVID 19 Liability Waiver

Receive signed liability waivers and e-signatures online with our free COVID-19 Liability Waiver form. Easy to customize and share. No coding is required.

COVID 19 Liability Release Waiver

COVID 19 Liability Release Waiver

Start collecting your participants' liability release waiver for this pandemic using this COVID-19 Liability Release Waiver Template. Just connect your device to the internet and load your form and start collecting your liability release waiver. Get this here in Jotform!

COVID 19 Vaccine Registration Form

COVID 19 Vaccine Registration Form

Collect COVID-19 vaccine registrations online. Fill out on any device. Easy to customize, share, and embed. Convert submissions to PDFs instantly. HIPAA option.

Coronavirus Self Declaration Form

Coronavirus Self Declaration Form

Employees can complete this form online and report any COVID-19 symptoms they may have. No coding is required. HIPAA compliance option.

Employee COVID 19 Self Screening Questionnaire

Employee COVID 19 Self Screening Questionnaire

Employee COVID-19 Self Screening Questionnaire tracks the health condition of your employee and helps to take the precautionary measures to prevent the spreading of coronavirus in the workspace. Fully customizable with no coding.

Screening Checklist For Visitors And Employees

Screening 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.

COVID 19 Vaccine Consent Form

COVID 19 Vaccine Consent Form

Collect signed COVID-19 vaccine consent forms online. Easy to customize, share, and fill out on any device. Upgrade for HIPAA compliance. Convert to PDFs instantly.

Passenger Disclosure And Attestation To The United States Of America

Passenger Disclosure And Attestation To The United States Of America

Follow CDC requirements with this free passenger attestment form for airlines and aircraft operators. Turns form submissions into PDFs automatically. No coding.

Negative COVID 19 Test Reporting Form

Negative COVID 19 Test Reporting Form

Receive submissions for COVID-19 test reports from your staff for your company or organization online. Use this Negative COVID-19 Test Reporting Form template and make your receiving process simple and manageable.

Coronavirus Case Report Template

Coronavirus 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.

New Patient Enrollment Form

New Patient Enrollment Form

New Patient Enrollment Form which personal information, contact information, emergency contact people area and medical history information are provided; allowing you to have an easier and faster registration process.

Coronavirus Screening Form

Coronavirus Screening Form

Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA compliance option.

Telehealth Consent Form

Telehealth Consent Form

Get informed consent from patients online. Collect legally binding electronic signatures. Easy to customize for your practice. HIPAA compliance option.

Sample Request Form

Sample Request Form

A sample request form is a quick and easy way to ask for examples of a product or service from a business.

Telemedicine Consent Form

Telemedicine Consent Form

Get consenting e-signatures online from your patients. Add terms and conditions without coding. Free HIPAA compliance option for coronavirus responders.

Mental Health Intake Form

Mental Health Intake Form

Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.

HIPAA Medical History Form

HIPAA 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.

Teletherapy Consent Form

Teletherapy Consent Form

Collect informed patient consent and e-signatures online with a free Teletherapy Consent Form. Great for remote medical services. Get HIPAA compliance today.

Nutrition Consultation Form

Nutrition Consultation Form

A nutrition consultation form is used by medical practices to record details about consultations with patients and their ongoing nutritional needs.

Virtual Care Appointment Form

Virtual Care Appointment Form

Easy appointment scheduling for e-visits. Great for telemedicine! HIPAA compliance option. Embed anywhere. Integrate with 100+ apps. No coding required.

CAHPS® Clinician & Group Survey Version 3.0 (Adult)

CAHPS® Clinician & Group Survey Version 3.0 (Adult)

Gather feedback from adult patients online. CAHPS® Clinician and Group Survey for healthcare providers. Add supplemental items from AHRQ. No coding required.

CAHPS® Cancer Care Radiation Therapy Survey

CAHPS® Cancer Care Radiation Therapy Survey

Readymade online CAHPS® survey. Collect feedback from cancer patients receiving radiation therapy. Fill out on any device. Upgrade for HIPAA compliance.

CAHPS® Child Hospital Survey

CAHPS® Child Hospital Survey

Ready-to-use CAHPS® survey for hospitals. Share with your patients’ parents to fill out on any device. Upgrade to protect data with HIPAA compliance.

CAHPS® Clinician & Group Survey Version 3.0 (Child)

CAHPS® Clinician & Group Survey Version 3.0 (Child)

Readymade CAHPS® survey for healthcare providers. Easy to share and fill out on any device. Customize with supplemental items provided by AHRQ. No coding.

CAHPS® Cancer Care Surgery Survey

CAHPS® Cancer Care Surgery Survey

Receive feedback from cancer surgery patients. Official CAHPS® Cancer Care Surgery Survey. Add supplemental items without coding. Fill out on any device.

CAHPS® Cancer Care Drug Therapy Survey

CAHPS® Cancer Care Drug Therapy Survey

Ready-to-use CAHPS® survey. Gather feedback from cancer patients regarding their drug therapy treatments. Fill out on any device. Upgrade for HIPAA compliance.

CAHPS® Health Plan Survey Version Adult Medicaid Survey 5.0

CAHPS® Health Plan Survey Version Adult Medicaid Survey 5.0

Get patient feedback about their current health plan. Free CAHPS® Health Plan Survey for medical organizations. Easy to share and fill out on any device. No coding.

CAHPS® Health Plan Survey Version Child Medicaid Survey 5.0

CAHPS® Health Plan Survey Version Child Medicaid Survey 5.0

Get patient feedback about their current health plan. Free CAHPS® Health Plan Survey for medical organizations. Easy to share and fill out on any device. No coding.

Patient Supplies Order Form

Patient Supplies Order Form

Keeping a clear and organized medical order in the healthcare business is important because it saves time and enhances the efficiency of their medical order. This patient supplies order form is mostly used by medical staff and hospitals. The objective of this form is to assist and help medical staff for keeping the records of used supplies by patients. The form will need information such as patient information and medical supply information. The costs incurred for each service and the materials are also needed to complete the form.

COVID 19 Daily Health Screening Form

COVID 19 Daily Health Screening Form

Receive coronavirus screening forms online. Great for students, clients, employees, and more. Easy to customize, embed, and share. Fill out on any device.

Palliative Care Assessment Form

Palliative Care Assessment Form

Classify the type of care that the patient with severe illness is needed by using this Palliative Care Assessment Form. This form is simple yet contains all necessary health questions to diagnose the patient correctly.

Hospice Patient Satisfaction Survey

Hospice Patient Satisfaction Survey

Hospice patient satisfaction surveys are inquiries used by medical providers to seek feedback from patients about their hospice care. Collect patient feedback with a free online Hospice Patient Satisfaction Survey.

Hospice Discharge Summary Form

Hospice Discharge Summary Form

A hospice discharge summary form is a paper form used by physicians to document medical information about the patient and their recent discharge from the hospital. Get paperless forms today!

Hospice Revocation Form

Hospice Revocation Form

An online hospice revocation form is used by medical practitioners to manage the revocation of their patient’s hospice.

Confidential Patient Information Form

Confidential Patient Information Form

A Confidential Patient Information Form is a form used by healthcare providers to protect the identity and private information of patients.

Hospice Care Checklist

Hospice Care Checklist

Hospice care is an alternative to traditional medical care that specializes in keeping terminally ill patients comfortable during their last days.

Hospice Certification Of Terminal Illness Form

Hospice Certification Of Terminal Illness Form

A hospice certification of terminal illness form is a document required by many hospitals and insurance companies. Start building your Hospice Certification of Terminal Illness Form now.

Hospice Consent Form

Hospice Consent Form

A hospice care consent form is used by medical organizations to enroll patients in hospice care programs. Get the consent you need easily with Jotform!

COVID 19 Liability Release Waiver

COVID 19 Liability Release Waiver

Start collecting your participants' liability release waiver for this pandemic using this COVID-19 Liability Release Waiver Template. Just connect your device to the internet and load your form and start collecting your liability release waiver. Get this here in Jotform!

Patient Photo Release Form

Patient Photo Release Form

Go paperless and immediately store your consent to your records. Use this Patient Photo Release Form template and get your photo release consent from patients immediately!

Release Of Medical Information Form

Release Of Medical Information Form

Disclosure of confidential information requires an authorization or permission from the owner. Use this form so owners can easily sign an authorized consent for the release of their information, whether they wish to release their medical records or other health information.

Covid 19 Questionnaire And Release Form

Covid 19 Questionnaire And Release Form

A Covid-19 questionnaire and release form is used by medical professionals to collect information from patients about the Covid-19 vaccine. No coding!

Permission And Medical Release Form

Permission And Medical Release Form

This is an interactive electronic version of the permission and medical release form used by the Church of Jesus Christ of Latter Day Saints. Note this was not made by the Church of Jesus Christ of Latter Day Saints nor is it endorsed by them. It was made for the individual purposes of the Oak Hills Stake Youth organization.

Precautionary Coronavirus Liability Release Form

Precautionary Coronavirus Liability Release Form

This COVID-19 Release Form is crafted specifically for spa industries to gather the consent of their customers to the service terms and precautionary conditions.

 Minors COVID 19 Liability Release Waiver

Minors COVID 19 Liability Release Waiver

This minors COVID-19 liability release waiver form is used by parents and/or guardians to grant permission for minors to receive the COVID- 19 vaccines. No coding!

Dental Records Release Form

Dental Records Release Form

A dental records release form is used by a dentist to collect patient’s medical records from their other doctors. The dental records release form can be customized to fit the way you conduct your business.

Authorization For Release Of Protected Health Information Form

Authorization For Release Of Protected Health Information Form

Secure yourself or your company when utilizing your patients or any person's health information in your possession properly. Get this Authorization For Release Of Protected Health Information Form template and start getting the proper consent right away!

Medical Report Form

Medical Report Form

A medical report form is a document used by medical professionals for documenting a patient’s medical treatment.

Screening Checklist For Visitors And Employees

Screening 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.

Patient Feedback Form

Patient 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.

Coronavirus Case Report Template

Coronavirus 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.

Patient Medical History Form

Patient 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.

Gym Health Questionnaire Form

Gym 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.

Skin Care Consultation Form

Skin Care Consultation Form

If you make a skin care consultation you can use this skin care consultation form to make an appointment for follow up check up. This facial consultation form template provides to collect contact information, skin information such as skin care goals, skin care challenges, skin care products that are used by the client, health information such as illnesses, allergies. Also, this skin consultation form template contains your policies and allows your policies to be accepted by your customers. You can collect your clients' signatures with this skin care client consultation form.

Contact Tracing Form

Contact 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.

Initial Visit Patient Forms (MDR)

Initial 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.

Medical Employment Information Form

Medical 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.

Other Healthcare Forms

COVID-19 Liability Waiver

COVID-19 Liability Waiver

Receive signed liability waivers and e-signatures online with our free COVID-19 Liability Waiver form. Easy to customize and share. No coding is required.

Healthcare Forms
COVID-19 Vaccine Registration Form

COVID-19 Vaccine Registration Form

Collect COVID-19 vaccine registrations online. Fill out on any device. Easy to customize, share, and embed. Convert submissions to PDFs instantly. HIPAA option.

Healthcare Forms
Coronavirus Self Declaration Form

Coronavirus Self Declaration Form

Employees can complete this form online and report any COVID-19 symptoms they may have. No coding is required. HIPAA compliance option.

Healthcare Forms
Medical History Form

Medical History Form

A medical history form is a questionnaire used by health care providers to collect information about the patient’s medical history during a medical or physical examination.

Health Tracking Forms
Online Doctor Appointment Form

Online Doctor Appointment Form

An online doctor appointment form is used by medical practices to schedule medical appointments through the practice website.

Healthcare Forms
New Patient Enrollment Form

New Patient Enrollment Form

New Patient Enrollment Form which personal information, contact information, emergency contact people area and medical history information are provided; allowing you to have an easier and faster registration process.

Healthcare Forms
Medical Report Form

Medical Report Form

A medical report form is a document used by medical professionals for documenting a patient’s medical treatment.

Healthcare Forms
Personal Training Consultation Questionnaire

Personal Training Consultation Questionnaire

A personal training consultation questionnaire is used by gym owners to gather contact information and fitness goals from potential personal training clients. Ensure your clients are motivated to achieve their fitness goals!

Healthcare Forms
Screening Checklist for Visitors and Employees

Screening 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.

Checklist Forms
COVID-19 Vaccine Consent Form

COVID-19 Vaccine Consent Form

Collect signed COVID-19 vaccine consent forms online. Easy to customize, share, and fill out on any device. Upgrade for HIPAA compliance. Convert to PDFs instantly.

Healthcare Forms
Patient Feedback Form

Patient 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.

Healthcare Forms
Negative COVID-19 Test Reporting Form

Negative COVID-19 Test Reporting Form

Receive submissions for COVID-19 test reports from your staff for your company or organization online. Use this Negative COVID-19 Test Reporting Form template and make your receiving process simple and manageable.

Healthcare Forms
Coronavirus Case Report Template

Coronavirus 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 Forms
Health Declaration Form

Health Declaration Form

A health declaration form is a document that declares the health of a person to the other party. See applicants' health history with a free health declaration form.

Coronavirus Response Forms
Hospital Discharge Form

Hospital Discharge Form

This hospital discharge form is suitable for hospitals and clinics worldwide. The staff of hospitals can use this form to ensure all requirements are meant before a patient is discharged. The form is very detailed and contains every essential information needed. However, if this sample hospital discharge form does not contain one or more fields you needed, you do need to worry. You can easily edit the sample discharge form to ensure that it meets your hospital's format. And editing this hospital discharge form is very simple. You do not need coding skills. Why not start using this form today to capture the information you need before discharging patients.

Healthcare Forms
Patient Medical History Form

Patient 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 Forms
Massage Therapy Client Intake

Massage Therapy Client Intake

Never thought you needed therapy? You can sign up for massage therapy with massage intake form template and you can create a HIPAA Compliant. Also, client intake form massage is used by Chiropractors. Massage therapy intake contains different questions about personal information, contact information, history of pathology and the client's symptoms.

Healthcare Forms
Coronavirus Screening Form

Coronavirus Screening Form

Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA compliance option.

Healthcare Forms
Professional Counseling Informed Consent Form

Professional Counseling Informed Consent Form

A Professional Counseling Informed Consent Form is a document provided by the counseling service to their clients in order to properly acquire consent from them treatment for mental health. The form contains information about the services and the agreement to be made by the counseling service and the client. By having this document, it also helps inform of the risks, limitations, and benefits of the treatment. This Professional Counseling Informed Consent Form is a direct and simple form for clients who wish to receive therapy, which may be used by the counsel for reference. It serves as a reference for the therapist in informing his or her client of the client's rights and what to expect in the sessions.

Healthcare Forms