Telehealth Forms

83 Templates

Telehealth forms help healthcare practices schedule virtual appointments with patients and collect medical records, informed consent, fee payments, and other important health data online. Whether you’re part of a doctor’s office, teletherapy practice, or dermatology center, you can use JotForm’s free telemedicine forms to securely gather important patient information and diagnose conditions through your website. Simply choose a readymade form template from the list below, customize it to match your practice by adding your logo and updating form fields, then embed it in your website or share it via email to start collecting info online.

To keep sensitive health data protected, be sure to sign up for HIPAA compliance by signing a Business Associate Agreement (BAA) — or if you’re switching to telehealth because of the COVID-19 pandemic, apply for a free unlimited HIPAA account through our Coronavirus Responder Program. You can even automatically send form submissions to other platforms you’re already using, like Google Calendar, Dropbox, Google Drive, and more. JotForm offers an all-in-one solution to collect important info from your patients online — so take your telemedicine practice to the next level with our free Telehealth Forms.

Telemedicine E-Visit Request Form

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Accept requests for e-visits through this free online appointment form. Easy to customize. embed, and share. Integrate with 100+ apps. HIPAA compliance option.

Healthcare Forms

Telemedicine Patient Evaluation Form

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Evaluate your patients remotely with an online Telemedicine Patient Evaluation Form. Easy to share and collect data on any device. Opt for HIPAA compliance.

Healthcare Forms

Telemedicine Appointment Form

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Let patients request virtual appointments online. Add a calendar field without coding. HIPAA compliance option. Perfect for telemedicine providers.

Healthcare Forms

New Patient Enrollment Form

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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

Coronavirus Screening Form

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

Healthcare Forms

Telehealth Consent Form

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

Healthcare Forms

HIPAA Medical History Form

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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

Telemedicine Consent Form

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

Healthcare Forms

Teletherapy Consent Form

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

Healthcare Forms

Virtual Care Appointment Form

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

Healthcare Forms

Telehealth Physical Therapy Consent Form

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Offering virtual physical therapy appointments? Collect signatures and payments from patients online. Easy to customize and integrate. HIPAA compliance option.

Healthcare Forms

Mental Telehealth Informed Consent Form

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Collect signed patient consent forms online with our free Mental Telehealth Informed Consent Form. Easy to customize and embed. Opt for HIPAA compliance.

Healthcare Forms

Mental Health Intake Form

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

Healthcare Forms

Telehealth Counseling Consent Form

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Collect consent forms and e-signatures with an online Telehealth Counseling Consent Form. Easy to customize and share. Opt for HIPAA compliance.

Healthcare Forms

Reiki Intake Form

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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.

Healthcare Forms

Dermatology Telehealth Medical Examination Form

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Treat patients remotely. Safely collect medical info online. HIPAA compliance option. Accept photos of skin conditions. 30+ free payment app integrations.

Healthcare Forms

Nutrition Consultation Form

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Nutrition Consultation Form is helping dietitians to collect client intakes and improve patients' nutrition and eating habits.

Telehealth Forms

Telehealth Clinical Assessment Form

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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.

Healthcare Forms

Medical Volunteer Application

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Collect medical volunteer registrations online with our free Medical Volunteer Application Form. Easy to customize and embed. Ideal for emergency response.

Healthcare Forms

Telehealth Patient Consent Form

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Get informed consent from patients for your telehealth services. Easy to customize and embed. Collect digital signatures. Integrate with 100+ apps. No coding.

Healthcare Forms

Sample Telemedicine Consent Form

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Collect informed consent and e-signatures from patients with a free Sample Telemedicine Consent form. Easy to customize, embed, and share. HIPAA option.

Healthcare Forms

Telehealth Intake and Signature Form

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Telehealth Intake and Signature Form helps your healthcare organization to get patient information and consent to participate in telehealth consultation with signatures.

Healthcare Forms

Teledentistry Consent Form

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Collect consent from patients online. Perfect for dental practices offering virtual care. Easy to customize and embed. Integrate with 100+ apps. No coding.

Healthcare Forms

Telehealth Waiver Form

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Secure a consent or waiver from your patients by using this Telehealth Waiver Form. This form contains form fields that ask all necessary information in securing a waiver in telehealth programs.

Healthcare Forms

Disclaimer

Noth­ing on this site is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment.