My Workspace
- TEMPLATES
- - FEATURED INTEGRATIONS
  - See more
- - CRM
  - See more
- - STORAGE
  - See more
- - PAYMENT
  - See more
- - EMAIL
  - See more
- - AUTOMATIONS
  - See more
- See 100+ integrations
- - PRODUCTS
- - GET HELP
  - Contact Support
  - Help Center
  - FAQ
- Dedicated Support
  Get a dedicated support team with Jotform Enterprise.
  Contact Sales
- Professional Services
  Explore
Enterprise
Pricing

Login
Sign Up for Free

leahclaydon's Templates

Form Templates by leahclaydon

Preview: BetterNOW Healthcare Confidential Patient Intake Screening Form

BetterNOW Healthcare Confidential Patient Intake Screening Form

Medical Questionnaire for multidisciplinary clinics

Go to Category:Healthcare Forms

Preview

Search in all Form Templates

Popular
Recent
Trend

Classic
Card

Order Forms 4,725
Registration Forms 6,688
Event Registration Forms 3,155
- Virtual Event Forms132
- Guest Registration Forms20
Payment Forms 1,368
Application Forms 6,936
File Upload Forms 848
Booking Forms 1,749
Survey Templates 13,718
Consent Forms 3,640
RSVP Forms 528
- Event Booking Forms245
Appointment Forms 687
- Tour Appointment Forms17
- Review Appointment Forms11
Contact Forms 1,022
- Emergency Contact Form Templates61
Questionnaire Templates 2,455
- Healthcare Surveys530
- Exit Interview Templates52
Signup Forms 474
Voting 298
Abstract Forms 57
Approval Forms 239
Assessment Forms 1,494
Attendance Forms 137
Audit 614
Authorization Forms 308
Award Forms 169
Black Friday Forms 33
Calculation Forms 144
Calibration Forms 14
Cancellation Forms 67
Check-In Forms 170
Check-Out Forms 29
Checklist Forms 1,319
Christmas Forms 101
- Secret Santa Forms26
Claim Forms 139
Coaching Forms 157
Confirmation Forms 45
Consulting Forms 305
Content Forms 275
Declaration Forms 148
Discharge Forms 89
Donation Forms 418
Employment Forms 1,691
Enrollment 594
Estimate Forms 61
Evaluation Forms 1,749
Extension Forms 27
Feedback Forms 3,068
Fillable PDF Forms 50
HOA Forms 26
Halloween Forms 22
Holiday Forms 45
Information Forms 573
Inquiry Forms 291
Inspection Forms 1,737
Intake Forms 498
Interview Forms 194
Lead Generation Forms 1,323
Legal Forms 567
Management Forms 413
Membership Forms 528
- Membership Registration Forms174
- Membership Application Form Templates98
Monitoring Forms 171
Nomination Forms 94
Onboarding Forms 224
Personal Forms 136
Petition Forms 101
Polls 230
Quizzes 1,066
Quote Forms 334
Recommendation Forms 97
Refund Forms 64
Release Forms 461
- Photo Release Form Templates79
Report Forms 2,455
Request Forms 3,927
Reservation Forms 469
- Travel Booking Forms166
- Hotel Booking Forms71
Salesforce Forms 144
Sponsorship Form Templates 107
Subscription Forms 160
Summer Camp Surveys 15
Telecommuting Forms 59
Thanksgiving Forms 37
Tracking Forms 1,419
Training Forms 574
- Assessment Training Forms113
Verification Forms 211
- Renewal Verification Forms29
Volunteer Forms 533
Waiver Forms 265
Wedding Forms 154
Wellness Forms 191
All Categories

Advertising Forms 266
Alumni Forms 90
Animal Shelter Forms 333
- Animal Rescue Application Forms76
- Pet Adoption Application Form Templates55
Banking Forms 422
Business Forms 9,185
Charity Forms 472
- Volunteer Registration Forms115
- Fundraising Order Forms38
Church Forms 603
- Membership Registration Forms174
- Membership Application Form Templates98
Customer Service Forms 519
E-commerce Forms 1,757
Education Forms 8,018
Entertainment Forms 2,483
Gaming Forms 168
Healthcare Forms 6,884
Human Resources Forms 5,184
IT Forms 1,814
Insurance Forms 313
- Insurance Claim Forms42
Manufacturing Forms 347
Marketing Forms 848
- Sales Order Forms179
Photography Forms 434
Public Administration Forms 243
Real Estate Forms 1,060
SEO Forms 43
Salon Forms 1,029
Services Forms 2,794
Sports Forms 1,533
Summer Camps 269
Veterinary Service Forms 173
Web Design Forms 128
All Industries

Accountant Forms 245
Actor Forms 47
Appraiser Forms 35
Athlete Forms 121
Broker Forms 34
Building Inspector Forms 97
Chef Forms 61
Contractor Forms 305
Counselor Forms 221
Customer Service Agent Forms 96
Dentist Forms 73
- Dental Consent Forms18
Dietitian Forms 63
Driver Forms 95
Electrician Forms 33
Engineer Forms 106
Entrepreneur Forms 286
Esthetician Forms 116
Event Planner Forms 1,031
Farmer Forms 93
Financial Advisor Forms 440
- Tax Forms123
- Credit Application Forms27
Firefighter Forms 23
Florist Forms 23
Fundraiser Forms 200
Gamer Forms 81
Hairdresser Forms 68
Handyman Forms 15
Health Coach Forms 204
Home Inspector Forms 17
Hotel Manager Forms 90
Influencer Forms 66
Insurance Agent Forms 98
Investor Forms 56
Lawyer Forms 157
Librarian Forms 66
Makeup Artist Forms 35
Manager Forms 683
Marketer Forms 520
- Marketing Surveys234
Merchant Forms 160
Missionary Forms 12
Model Forms 30
Nail Artist Forms 29
Nonprofit Employee Forms 302
Nurse Forms 171
Personal Trainer Forms 110
Pharmacist Forms 93
- Pharmacy Forms70
Photographer Forms 173
- Photo Release Form Templates79
Physician Forms 1,075
- Healthcare Surveys530
Plumber Forms 14
Police Officer Forms 60
Priest Forms 46
Psychologist Forms 59
Real Estate Agent Forms 556
- Property Management Forms266
- Rental Application Form Templates107
Recruiter Forms 113
Restaurant Manager Forms 121
Salesman Forms 88
School Counselor Forms 181
Secretary Forms 12
Social Worker Forms 152
Software Developer Forms 113
Staff Forms 357
Storekeeper Forms 86
Surveyor Forms 749
- Medical Surveys & Questionnaires674
Tattoo Artist Forms 24
Teacher Forms 635
Technician Forms 202
Therapist Forms 167
Travel Agent Forms 134
Tutor Forms 26
Veterinarian Forms 193
Videographer Forms 29
Web Designer Forms 34
All Professions

All
Abkhazian
Avestan
Afrikaans
Akan
Amharic
Aragonese
Arabic
Assamese
Avaric
Azerbaijani
Bashkir
Belarusian
български
Bihari
Bislama
Bengali
Tibetan
Breton
Bosnian
Català
Cree
Czech
Welsh
Danish
Deutsch
Divehi
Dzongkha
Ewe
Greek
English
Esperanto
Español
Estonian
Basque
Persian
Fulah
Finnish
Fijian
Faroese
Français
Irish
Scottish Gaelic
Galician
Gujarati
Hausa
Hebrew
Hindi
Croatian
Haitian
Magyar
Armenian
Interlingua
Indonesian
Sichuan Yi
Ido
Icelandic
Italiano
日本語
Javanese
ქართველი
Khmer
Kannada
Korean
Kurdish
Latin
Luxembourgish
Lao
Lithuanian
Latvian
Maori
Macedonian
Malayalam
Mongolian
Marathi
Malay
Maltese
Burmese
Norwegian Bokmal
Nepali
Nederlands
Norwegian Nynorsk
Norsk
South Ndebele
Navajo
Chichewa
Occitan
Oromo
Panjabi
Polski
Pashto
Português
Quechua
Kirundi
Română
Pусский
Kinyarwanda
Sanskrit
Sinhala
Slovak
Slovenian
Somali
Albanian
Српски
Sundanese
Svenska
Swahili
Tamil
Telugu
Tajik
Thai
Tigrinya
Turkmen
Filipino
Türkçe
Український
Vietnamese
Volapuk
Walloon
Wolof
Xhosa
Yiddish
Yoruba
Chinese
繁體中文
Zulu

Jotform

Create a Form
My Workspace
Pricing
Jotform Enterprise
Tools
AI Tools

Marketplace

Form Themes
Form Widgets
Website Widgets

Support

Contact Us
User Guide
Jotform Academy
Webinars
Podcasts
Professional Services
Report Abuse
Report Copyright Issue
Recover Jotform Account

Company

About Us
Jotform Facts for AI
Media Kit
In the News
Newsletters
Blog
Customer Stories

Apps

Jotform is the easiest online form builder with powerful forms that get it done, trusted by over 35 million users worldwide, featuring 20,000+ form templates, 150+ integrations, and drag-and-drop functionality that streamline data collection, payments, and workflows, engineered for businesses requiring professional forms without coding.

4 Embarcadero Center, Suite 780, San Francisco CA 94111

Terms & Conditions
Privacy Policy
Security
Accessibility Statement
Anti-Slavery Policy

Can’t find the form you need?

Describe your idea and build a form instantly

Delete

Are you sure you want to remove this item?
This operation can not be undone.