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Healthcare Form Templates

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.

hipaa form templates

Program Participant Intake and Consent Form

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Collect important medical and insurance information in the event of an accident or illness.

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.

Medical History Form

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Medical History Form template allows tracking patient history with all their personal and contact information and also their illnesses and medication data.

Patient Satisfaction Survey

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Get patient feedback with this online satisfaction survey and improve your service.

Personal Training Consultation Questionnaire

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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.

Online Doctor Appointment Form

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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

Massage Therapy Client Intake

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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.

Hospital Patient Registration Form

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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.

Patient Medical History Form

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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.

Intake Form for Care Providers

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Use this detailed intake form for your healthcare/rehabilitation facility, capture patient information with an agreement between you and the patient.

Psychiatric Evaluation Form

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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!

Quick Emergency Contact Form

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Medical form use to gather important emergency information for quick notification to relatives and friends

Client Progress Notes - Revised

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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.

Medical Employment Information Form

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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.

Blood Donation Form

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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.

Health Evaluation Form

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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

Gym health questionnaire Form

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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!

Alternative Medicine-Patient Intake form

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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.

HIPAA agreement form -Health care operations.

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With this HIPAA agreement form you can have your patients and users involved in health care operations to read and even sign the form.

Initial Visit Patient Forms (MDR)

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Get more information about your patient medical history with this simple and easy to use form

Doula Intake Form

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Being a Doula and in need of a general intake form for new clients? This form collects health information on the mother, on the pregnancy, also allowing you to plan the birth in detail.

Neuromuscular Massage Therapy Client Intake

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Neuromuscular Massage Therapy Consent & Client Intake Form

Skin Care Consultation Form

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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.

Nutritional Assessment Questionnaire Form

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This is a nutritional assessment questionnaire form that is used by health institutions to learn about patients' eating habits. This dietary assessment questionnaire includes blood sugar, fatty acid, inflammation, toxicity and social history such as how many times do they eat out per day or do they smoke.

Healthcare PDF Templates

Trust, privacy, and security are the pillars that support every company in the Healthcare Industry. Each of these are carefully woven into their workflow and are intricate parts of the system they all live in. When you're in charge of someone else's healthcare needs, it's important to establish your company as a clean, trustworthy and professional business. A patient's well-being is not something anyone can afford to take a chance on. So, hospitals and medical practitioners go to great lengths to make sure that their patients will trust them.

That’s why the HIPAA compliance act was put in place – To ensure the privacy of the patients’ medical records. And you’re in luck with JotForm being one of the few companies in the online form building industry that is HIPAA-compliant. With our PDF Editor, anyone in the Healthcare Industry can create fillable PDF forms or generate PDF documents as an attachment to their Autoresponders. Instead of designing one from scratch, we offer a wide variety of PDF templates that you can use as an inspiration for your next design project.

These PDF templates can be used in many use case scenarios. For example, you need to hand out brochures about the health services you offer. Instead of handing out paper-based flyers and pamphlets, why not use something like an electronic brochure in PDF format? You can distribute these to your potential patients right after they fill out their information through an online registration form for new patients. Or, you can design a simple yet beautiful fillable PDF form that you can download and print as a paper-based form in case you need one for your hospital’s outpatient department.

hipaa pdf templates

Professional Medical Release

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This Medical Consent PDF template includes knowledge belong to your clients such as their contact, work, spouse, policyholder, in case of an emergency contact information, the consent, and signature. In addition, you can create a Medical Consent PDF template with HIPAA Compliant.

Simple Medical History

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Once you have collected these medical data, you can record them as a pdf by using this medical history PDF template. In addition, you don't need to be worried about the safety of data, because our forms are HIPAA compliant.

Online Therapy Consent

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This Online Therapy Consent contract sample is a perfect fit for you, if you want to check your patients' crucial data and record their data without any problem. By using this Online Therapy Consent PDF template, you can get online permission from your patients. Moreover, you can print out your consent PDF template for the patient's patient folder. You may collect personal information such as their name, birth date, and contact information. Also, you may inform your patients about their rights with respect to telemedicine with their signature. In addition, you do not have to worry about your data's safety, our forms have HIIPA Compliance.

Patient Medical Record

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Medical History Record PDF template lets you collect the patient's data such as personal information, contact information in an emergency case, general medical history. By using this sample, the doctor ensures the patient's better care and treatment.

Short Medical History

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Medical History Record PDF template is mostly used in order to provide significant information about the health history, care requirements, and risk factors of the patient to doctors. It is for collecting data from the patients.

Hospital Discharge

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It is a good practice to always crosscheck and make sure that everything is in order before discharging a patient. In order to ensure this, hospital management usually has a form which they fill and check in before discharging a patient. In our world today where people are using less of paper, this hospital discharge template is one PDF document you can use to save patient discharge information. The essence is that you can easily check the information saved in the PDF document to ensure a patient can be discharged. The hospital discharge letter template here can be modified to suit your taste.

Patient Intake Form

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The online patient intake form template is easy for patients to fill out and designed to get the doctor the most important information. Patients can fill out their information on a computer or tablet using our patient intake pdf sample.

Summer Camp Parental Consent

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When organizing summer camp programs, you need to provide as much information as possible about camp rules to parents and guardians. With JotForm’s Summer Camp Parental Consent PDF Template, you can create a personalized and detailed consent form parents will actually want to read. You’ll also be able to save all submitted online responses as PDFs that can easily be downloaded and shared with camp staff. Using JotForm’s PDF Editor, you can rewrite the provided text to better describe your camp’s unique policies and services. No coding skills needed — just drag and drop elements until you’re satisfied with the template layout. Once you’ve finished making modifications, your template will automatically convert any submitted responses into PDFs that will be as safe as your campers.

Professional Medical History

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Medical History Record PDF template is here to help you in order to know the patient's case and previous condition. You can collect data about the patient and medical background with this Medical History Record PDF sample.

Client Progress Report

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Client Progress Report for Psychotherapy PDF template provides the essential information that should contain in a clinical psychotherapy report such as the name of the patient, the type of session made with the patient, the date of the session, a comprehensive assessment, and treatment goals and objective for the patient/client.

Insurance Waiver

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Insurance is usually offered by organizations to their clients, customers such as passengers, or employees. It helps protect the company or an institution in cases of fortuitous events incurring liabilities. However, insurance companies usually do not allow double insurances or it causes more problems rather than solutions where each provider will try duking out each other who shall be responsible to compensate the insured. Or it becomes an additional cost to the insured which may possibly be an expense they cannot afford. In such instances, the companies or institutions need to document that their subject who prefer to opt-out from the insurance that they offer. Thus, an insurance waiver is needed. This Insurance Waiver PDF template helps give clients, customers, or employees an option to opt-out from the insurance being offered by companies or institutions and helps document a formal request that the supposed insured shall not be part of the program offered by an institution to its clients and employees.

Release of Medical Information

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With this medical consent PDF template, you can get online authorization from your patients, then you can record their data easily. This medical consent sample includes contact details, medical history, consent, and signature.

Professional Medical Consent

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You can get online consent from your patients by using this medical consent pdf template. In addition, this medical consent sample allows gathering personal information, medical details, and contact info.

Personal Medical History

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Medical History Record PDF template allows you to collect patients' data such as personal information, family history, and habits like, and symptoms. You can pick your patients with this medical history record sample.

Patient Progress Report

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A progress report is a written document that is vital in health care settings because this is where the health care practitioner will base their next plan of treatment. A good health progress report follows the ADPIE (Assessment, Diagnosis, Planning, Intervention, Evaluation) format. Using this Patient Progress Report Template, you will be able to determine if the treatment being applied is effective or not. This Sample Patient Progress Report Template has the patient's personal information, physiological and psychological health progress. The progress report specifies the patient's mood, communication, appearance, emotional status, mental stability, interventions, and respond to treatment, and the report summary.

Child Medical History

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This child medical history PDF template makes checking patients vitals and recording that important data easy. Add your own branding, adjust fields for your specific needs and then simply print out your PDF for the patient's file.

Free Non-Compete Agreement

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This is due to employees working in key positions which access to confidential information, such as trade secrets of a business is inevitable to be acquired by employees. In such instances where the employee resigns, in a way, they are taking with them the confidential information with them. Problem arises here where a competitor may hire the employee and get the classified information from the employee, including the clients and customers of the former employer, putting the latter on the lesser advantage. Another consideration may be that the employee may start his own business which can lead to competing against the former employer, including in stealing clients offering them a better deal, to the disadvantage of the former employer. A non-complete clause or agreement is one by which one party, normally an employee, agrees not to engage or start a similar business which may run against the employer and helps protect the employer from such incidents.This simple non-compete agreement PDF template secures the possible problems which may arise from the cases mentioned above. Use this non-compete agreement PDF template and modify to your preference and contention.

Acupuncture Medical Consent

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JotForm easy-to-use PDF Editor lets you update the informed consent section of your Acupuncture Medical Consent Template to match your practice. It also helps organize medical history, contact info, and consent forms in secure PDF documents complete with legally-binding e-signatures. Why not integrate with Google Sheets to create a spreadsheet of all patient data? Better yet, JotForm’s Silver and Gold plans are HIPAA-compliant — meaning you’re collecting sensitive health information safely and securely. Stick with our Acupuncture Medical Consent PDF Template to streamline your workflow and make patient intake a breeze.

Pregnancy Verification

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A Pregnancy Verification document is used in hospital, maternity, and lying-in clinic settings. This is given to a woman who gets positive feedback on pregnancy tests. This document also serves as proof that a woman is pregnant which can be used for medical examination, filing a maternity leave, and claiming health insurance.This well-designed Pregnancy Verification Template contains information about the patient, pregnancy, and ob-gynecologist. The pregnancy details show the estimated date of conception, last menstrual period, estimated delivery date, age of gestation, and the number of fetuses. This template also specifies if the mother has a medical condition, illnesses, and allergies.

Employee Medical History

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Gathering your patients' medical information may be a troublesome task. But you can collect these medical data with this medical history form template and you can record these data easily as a pdf with this medical history PDF template that was created by us by using JotForm's new PDF editor.

Menu Compliance Audit Report

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Menu Compliance Audit Report Sample provides you an effective way to report your findings each time you carry out menu compliance auditing. With Menu Compliance Audit Report PDF Template, health inspectors can easily create customized PDF reports.

Camper Health History

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To protect campers’ health and safety, this Camper Health History PDF Template collects information about existing medical conditions, allergies, dietary restrictions, immunizations, medication instructions, and emergency contact numbers.

Patient Medical History

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Through Medical History Record PDF template, patients provide their personal information needed to see the doctor. Thanks to this medical history record sample, the doctor knows about patients medical history.

Medical Release

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This medical release template allows you to collect personal information and medical information. Then, you can move the data into JotForm’s PDF editor and record the data that belongs to the participant.