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

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.

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

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.

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.

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

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.

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

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.

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.

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!

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

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 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.

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.

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.

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.

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

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 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.

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

Get informed consent from patients online. Collect electronic signatures. Easy to customize for your practice.

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

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

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

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

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.

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

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

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

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

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.

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

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

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.

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

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.

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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.

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

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 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.

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!

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!

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

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

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

A hospice sponsorship form is a grant application used by charities to raise funds for hospice care programs. Get your charity fundraising off the ground with a free online Hospice Sponsorship Form.

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!

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!

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.

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

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.

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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.

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.

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!

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!

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

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.

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.

People can report suspected cases of COVID-19 in their workplace or community. Easy to customize, integrate, and share online. No coding required.

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.

A gym health questionnaire is a health form that is used by gym instructors to track the health and fitness of their clients.

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.

Reduce the spread of coronavirus with a free online Contact Tracing Form. Ideal for hospitals, medical organizations, and nonprofits. Collect data on any device.

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.

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.