Medical Surveys & Questionnaires

424 Templates

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.

Screening Checklist for Visitors and Employees

Preview

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 Forms

Patient Feedback Form

Preview

Get patient feedback with this online feedback form and improve your service.

Healthcare Forms

Coronavirus Case Report Template

Preview

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

Patient Medical History Form

Preview

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

Contact Tracing Form

Preview

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

Medical Surveys & Questionnaires

Gym health questionnaire Form

Preview

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 Forms

Skin Care Consultation Form

Preview

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.

Medical Surveys & Questionnaires

Medical Report Form

Preview

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

Abstract Forms

Initial Visit Patient Forms (MDR)

Preview

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 Forms

Medical Employment Information Form

Preview

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 Forms

Health Evaluation Form

Preview

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 Forms

COVID-19 Questionnaire

Preview

Record information about families in need. Free questionnaire for nonprofits. Easy to customize and embed. Integrate with 100+ apps. No coding required.

Medical Surveys & Questionnaires

COVID-19 Vaccine Survey

Preview

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.

Healthcare Forms

COVID- 19 Contact Tracing Register

Preview

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.

Business Registration Forms

Medical Questionnaire

Preview

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 Forms

Alternative Medicine-Patient Intake form

Preview

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.

Healthcare Forms

Nutritional Assessment Questionnaire Form

Preview

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 Forms

Patient Health Questionnaire

Preview

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.

Healthcare Forms

Counseling Intake Form

Preview

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 Forms

Veterinary EMR

Preview

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 Forms

Health Survey

Preview

Get health information of people with this online survey and create a huge database.

Healthcare Forms

HIPAA Medical History Form

Preview

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 Forms

SPEECH/LANGUAGE PATHOLOGY PROGRESS NOTE

Preview

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.

Healthcare Forms

COVID-19 Screening Questionnaire for Dental Patients

Preview

A COVID-19 Screening Questionnaire for Dental Patients is used by dental providers to gather information from patients about their general health conditions regarding the COVID-19 epidemic.

Healthcare Forms

Disclaimer

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.