Healthcare Form Templates

Our collection of online healthcare form templates makes it easier to register new patients and learn about their medical history. Jotform’s online 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 customizing your own. Additionally, Jotform offers a simple way to update medical history, acquire consent e-signatures, collect bill payments, find new business, and more. Jotform also offers HIPAA compliance features so your healthcare forms stay secure.

Form Templatess Form Templatess

Medical History Form

A medical history form is a questionnaire used by health care providers to collect information about the patient’s medical history during a medical or physical examination.

Medical Report Form

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

Online Doctor Appointment Form

An online doctor appointment form is used by medical practices to schedule medical appointments through the practice website.

COVID 19 Liability Waiver

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.

COVID 19 Vaccine Registration Form

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

Coronavirus Self Declaration Form

Employees can complete this form online and report any COVID-19 symptoms they may have. No coding is required. HIPAA compliance option.

New Patient Enrollment Form

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.

Personal Training Consultation Questionnaire

A Personal Training Consultation Questionnaire is a form template designed to streamline the process of signing up for personal training sessions, setting exercise goals, and mitigating exercise-related injuries

Screening Checklist For Visitors And Employees

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.

Physician Release To Return To Work Form

A Physician Release to Return to Work Form is a form template designed to showcase an employee's fitness to return to work after a period of illness or injury

Patient Feedback Form

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.

Patient Medical History Form

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.

Negative COVID 19 Test Reporting Form

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.

COVID 19 Vaccine Consent Form

Collect signed COVID-19 vaccine consent forms online. Easy to customize, share, and fill out on any device. Upgrade for HIPAA friendly features. Convert to PDFs instantly.

Coronavirus Case Report Template

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

Patient Supplies Order Form

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.

Hospital Discharge Form

This hospital discharge form is suitable for hospitals and clinics worldwide. The staff of hospitals can use this form to ensure all requirements are meant before a patient is discharged.

Health Declaration Form

The Health Declaration Form template offered by Jotform is a convenient and efficient way to collect important health information from travelers, patients, employees, event attendees, students, and visitors to public places

Professional Counseling Informed Consent Form

A Professional Counseling Informed Consent Form is a form template designed to collect consent from clients and inform them about the risks and limitations involved in professional counseling services

Massage Therapy Client Intake Form

A Massage Therapy Client Intake Form is a form template designed to collect important details from clients seeking massage therapy services.

Coronavirus Screening Form

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

Gym Health Questionnaire Form

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

COVID 19 Vaccine Survey

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 friendly features.

Online Medical Consent Form

This excellent Online Medical Consent Form has form fields that ask about the patient information, parent/guardian or emergency contact details, medical data, and the consent waiver. In order to fully acknowledge the consent, this template is using the E-signature widget where the patient can sign digitally.

Healthcare PDF Templates

Trust, privacy, and security are the pillars that support every company in the healthcare industry, and they’re intricately woven into the healthcare workflow. When you’re in charge of someone else’s healthcare needs, it’s important to establish your company as a sanitary, trustworthy, and professional business. A patient’s emotional and physical well-being is of the utmost importance, so hospitals and medical practitioners go to great lengths to make sure that their patients trust them.

That’s why we offer HIPAA compliance features — to ensure patients’ privacy as it relates to their medical records. Jotform is one of the few companies in the online form building industry that helps HIPAA compliance. 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 a PDF from scratch, we offer a wide variety of templates you can choose from as inspiration for your next design project.

These PDF templates can be used for many different use cases. For example, let’s say you need to hand out brochures about the health services you offer. Instead of giving 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. Or you can design a simple yet professional fillable PDF form that can be downloaded and printed as a paper-based form in case you need one for your hospital’s outpatient department.

PDF Templatess PDF Templatess

Patient Medical Record Template

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.

Doctors Note Template

Create a doctor’s note for your medical practice. Sign and send to your patients. Works on mobile, tablet, and desktop devices. Drag and drop to design.

Simple Medical History Template

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.

Medical Invoice Template

Generate PDF invoices for patients with this free, easy-to-customize Medical Invoice Template. Send to patients automatically with an autoresponder.

Vaccination Record Card

Give this Vaccination Record Card to the individual who receives the vaccine and remind them to return for another dose if needed. This PDF template shows all the information needed by the individual about the vaccination process.

Prescription Template

Use this Prescription Template when prescribing medications or providing treatment regimens to the patients in order to address their health complaints. This PDF document can be opened on mobile devices by using a mobile browser and then opening the standard direct link.

Pregnancy Verification Template

Verify the pregnancies of your clinic’s patients easily. Drag and drop to customize your form. Send out copies. Works on desktop, tablet, and mobile devices.

Short Medical History

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.

Online Therapy Consent Template

Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.

Client Progress Report

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.

Release of Information Template

Create a release of information document in seconds. Works great on any device. Easy to share and collect e-signatures. Drag and drop to customize. No coding needed.

Professional Medical Release Template

Create a professional medical release template. Great for medical practices and therapists. Collect signatures online. Converts to PDF. Easy to customize and share.

Insurance Waiver Template

Create an insurance waiver for employees declining insurance coverage. Works great on any device. Easy to customize and share. No coding knowledge required.

COVID-19 Vaccine Administration Record

Keep track of patient vaccination records online. More secure with GDPR, CCPA, and optional HIPAA compliance features. Download or print as PDFs. Free, easy-to-customize template.

Professional Medical History Template

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.

Medical Records Release Authorization

Build a medical records release authorization form in seconds. Works on any device. Android and iOS compatible. Converts to a PDF. No coding knowledge required.

Dental Health Record Template

The Dental Health Record 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 Dental Health Record Template.

Patient Progress Report Template

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.

Summer Camp Parental Consent

Create a summer camp consent form for parents of your campers. Intuitive form building. No coding required. Drag and drop to design. iOS and Android compatible.

Personal Medical History Template

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.

First Aid Incident Report Template

Incidents must be reported and recorded to be sure that correct actions and treatment are made which should trigger management awareness and an investigation. The First-Aid Incident Report template contains injured person's personal details and contact details, the details and visible symptoms of injury, the Glasgow Coma Scale which is a neurological scale that expects to give a dependable and target method for chronicle the condition of an individual's awareness and brief information of treatment. Also, it contains the profile of the first-aider and signature of the person who prepares the report.

Dietary Requirements Template

Collect important information about food restrictions and allergies. Save submissions as PDFs. Easy to customize, download, print, and share with kitchen staff.

Child Medical History Template

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.

Professional Physical Therapy Consent Template

Create a professional physical therapy consent form. Collect e-signatures on any smartphone, tablet, or desktop. Easy to customize and share.

JOTFORM ENTERPRISE

Get professional solutions with Jotform Enterprise

Discover how Jotform Enterprise can benefit your organization. Automate, collaborate, and scale with ease.