Healthcare Forms
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.
Gym Health Questionnaire Form
Do you need gym health questionnaire and searching for some gym questionnaire examples? Well, this is the simplest and easiest gym questionnaire template you can ever find. Let's check this out!
Health 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
Initial Visit Patient Forms (MDR)
Get more information about your patient medical history with this simple and easy to use form
Alternative 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. This holistic health intake form will help you to gather your patients' current diet information, health concerns, lifestyle information, education, physical activity, etc. You can create a HIPAA Compliant holistic nutrition intake form today.
Medical 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.
Nutritional 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.
Veterinary 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.
Patient Health Questionnaire
If you have an online health service , this forms is suitable for you. Get your patient to fill the form so that you can be able to diagnose them.
Health Survey
Get health information of people with this online survey and create a huge database.
SPEECH/LANGUAGE PATHOLOGY PROGRESS NOTE
Here is a simple speech therapy progress notes template made for language therapists and healthcare provider/practitioners. This sample speech therapy progress notes will allow you to gather all the necessary information to keep the progress of your patients. By using this form template, you can also schedule appointments and make bookings for your patients.
Coronavirus Self Declaration Form
Employees can complete this form online and report any COVID-19 symptoms they may have. No coding required. HIPAA compliance option.
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!
Beauty Salon COVID 19 Liability Waiver
This COVID-19 Liability Waiver is for Salon businesses to ensure their customers' acknowledgment of the possible risks of a salon service during the pandemic and reminds the measures that can be taken to avoid such risk. This Beauty Salon COVID-19 Liability Waiver provides you with your customers' personal and contact information and their signature to the condition statements. You can customize the template through JotForm's Form Builder, add, remove or change fields, add your own content, change the fonts, colors, background, and either embed it to your website or use it as a standalone form.
COVID 19 Volunteer Application Form
Nonprofits can collect volunteer applications online with our free COVID-19 Volunteer Application Form. Easy to customize and embed. Sync with 100+ apps.
Coronavirus Self Assessment Form
Stay on top of COVID-19 prevention with a free online Coronavirus Self-Assessment Form. Send to patients who may have the virus. Collect data from any device.
Coronavirus Intake Form For Massage Therapy
Make sure massage clients are healthy before their spa appointment. Free intake form for massage therapists. Easy to customize, share, and integrate. No coding.
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.
Coronavirus Screening Form
Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA compliance option.
Health Declaration Form
Sharing this Health Declaration Form that is intended to be used by many businesses is based on the Health Declaration Forms used by the Philippine House of Representatives and Malacañan Palace in relation to the COVID19 response. You can choose the option to encrypt the responses with JotForm to ensure the privacy of responses from our customers. Together, #WeRecoverAsOne!
COVID 19 Questionnaire
Record information about families in need. Free questionnaire for nonprofits. Easy to customize and embed. Integrate with 100+ apps. No coding required.
Telehealth Consent Form
Get informed consent from patients online. Collect legally binding electronic signatures. Easy to customize for your practice. HIPAA compliance option.
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.
Telehealth Physical Therapy Consent Form
Offering virtual physical therapy appointments? Collect signatures and payments from patients online. Easy to customize and integrate. HIPAA compliance option.
Mental Health Intake Form
Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.
Telehealth Counseling Consent Form
Collect consent forms and e-signatures with an online Telehealth Counseling Consent Form. Easy to customize and share. Opt for HIPAA compliance.
Reiki Intake Form
Collect client contact info and e-signatures online with a free Reiki Intake Form. Easy to customize, embed, and fill out on any device. Sync with 100+ apps.
Dermatology Telehealth Medical Examination Form
Treat patients remotely. Safely collect medical info online. HIPAA compliance option. Accept photos of skin conditions. 30+ free payment app integrations.
Telehealth Clinical Assessment Form
Assess the medical condition and health status of the patient online by using this Telehealth Clinical Assessment Form. This form template is simple, clean, and easy to use.
Telemedicine E Visit Request Form
Accept requests for e-visits through this free online appointment form. Easy to customize. embed, and share. Integrate with 100+ apps. HIPAA compliance option.
Telemedicine Patient Evaluation Form
Evaluate your patients remotely with an online Telemedicine Patient Evaluation Form. Easy to share and collect data on any device. Opt for HIPAA compliance.
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® 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® 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® 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
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
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
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® 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.
Other Healthcare Forms
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.
Coronavirus Response FormsCoronavirus Self Declaration Form
Employees can complete this form online and report any COVID-19 symptoms they may have. No coding required. HIPAA compliance option.
Healthcare FormsNew 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 FormsMedical History Form
Medical History Form template allows tracking patient history with all their personal and contact information and also their illnesses and medication data.
Healthcare FormsPersonal Training Consultation Questionnaire
A training questionnaire collecting personal and contact, health, medication, habitual(smoking), occupational, physical information; with areas to fully understand the customer expectation and with package options to select from.
Healthcare FormsOnline Doctor Appointment Form
The template simplifies the process of scheduling doctors appointment with new and recurring patients through collecting relevant information of the patient and appointment. You can create a HIPAA compliant Appointment Form today
Healthcare FormsPatient Feedback Form
Get patient feedback with this online feedback form and improve your service.
Healthcare FormsMassage 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 FormsHospital Patient Registration Form
Through the Hospital Patient Registration Form, you can collect all necessary data of your patients' health related information as their name, birthday, health history, family doctor, emergency contact information and more.
Healthcare 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 Self-Assessment Form
Stay on top of COVID-19 prevention with a free online Coronavirus Self-Assessment Form. Send to patients who may have the virus. Collect data from any device.
Healthcare FormsCoronavirus Intake Form for Massage Therapy
Make sure massage clients are healthy before their spa appointment. Free intake form for massage therapists. Easy to customize, share, and integrate. No coding.
Healthcare FormsGym health questionnaire Form
Do you need gym health questionnaire and searching for some gym questionnaire examples? Well, this is the simplest and easiest gym questionnaire template you can ever find. Let's check this out!
Healthcare FormsPsychiatric Evaluation Form
Use this neat and well-detailed psychiatric evaluation form to collect information about your psychiatric patients. This psychiatric evaluation form template can be customized to collect family history, list out symptoms and fields to input your examinations. Through JotForm your psychiatric evaluation template has access to an assortment of widgets and apps to make collecting the evaluation information easier. Get started with this our psychiatric evaluation form sample for a head start or create your own blank psychiatric evaluation form. Create a HIPAA compliant psychiatric evaluation form template today!
Healthcare FormsCoronavirus Screening Form
Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA compliance option.
Healthcare FormsIntake Form for Care Providers
Use this detailed intake form for your healthcare/rehabilitation facility, capture patient information with an agreement between you and the patient.
Healthcare FormsClient Progress Notes - Revised
Do you want to follow your clients progress notes? Create a HIPAA Compliant client progress notes sample and revised your psychotherapy client notes. Client progress notes template has personal information and five different classifications such as presentation assessment, safety and medical issues, subjective/objective part, interventions, and objectives and progress part.
Evaluation 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 FormsHIPAA agreement form -Health care operations.
With this HIPAA agreement form you can have your patients and users involved in health care operations to read and even sign the form.
Healthcare FormsBlood Donation Form
This blood donation form lets you provide a health clinic, hospital, or blood bank with the information they need to add you to their subscriber link for blood donors. Donors will submit their contact information and blood type to the clinic, securely. JotForm offers HIPAA compliance, so even the most sensitive patient data is safe. As is the case with all of JotForm’s form templates, this blood donation form is completely customizable. Add your logo, colors, images and more and start building out your list of blood donors today.
Healthcare FormsQuick Emergency Contact Form
Collect emergency contact numbers from employees, patients, and more. Easy to customize. Works on any device. Integrate with 100+ apps for free. No coding.
Contact 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 FormsInitial Visit Patient Forms (MDR)
Get more information about your patient medical history with this simple and easy to use form
Healthcare FormsHealth Declaration Form
Sharing this Health Declaration Form that is intended to be used by many businesses is based on the Health Declaration Forms used by the Philippine House of Representatives and Malacañan Palace in relation to the COVID19 response. You can choose the option to encrypt the responses with JotForm to ensure the privacy of responses from our customers. Together, #WeRecoverAsOne!
Healthcare Forms