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.

Form Templatess Form Templatess

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 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.

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.

Online Doctor Appointment Form

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

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 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.

Medical Report Form

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

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.

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 compliance. Convert to PDFs instantly.

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.

Hospital Patient Registration Form

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.

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.

Health Declaration Form

Sharing this Health Declaration Form that is intended to be used by many businesses is based on the Health Declaration Forms used by the Philippine House of Representatives and Malacañan Palace in relation to the COVID19 response. You can choose the option to encrypt the responses with Jotform to ensure the privacy of responses from our customers. Together, #WeRecoverAsOne!

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. The form is very detailed and contains every essential information needed. However, if this sample hospital discharge form does not contain one or more fields you needed, you do need to worry. You can easily edit the sample discharge form to ensure that it meets your hospital's format. And editing this hospital discharge form is very simple. You do not need coding skills. Why not start using this form today to capture the information you need before discharging patients.

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.

Massage Therapy Client Intake

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.

Coronavirus Screening Form

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

Physician Release to Return to Work Form

Collect physician releases and e-signatures for your HR department with this online Physician Release to Return to Work Form. Free to use, easy to customize.

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.

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.

Initial Visit Patient Forms (MDR)

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.

Coronavirus Self-Assessment Form

Stay on top of COVID-19 prevention with a free online Coronavirus Self-Assessment Form. Send to patients who may have the virus. Collect data from any device.

Coronavirus Intake Form for Massage Therapy

Make sure massage clients are healthy before their spa appointment. Free intake form for massage therapists. Easy to customize, share, and integrate. No coding.

HIPAA agreement form -Health care operations.

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

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.

PDF Templatess PDF Templatess
Doctors Note
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Doctors Note

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.

Patient Medical Record
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Patient Medical Record

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.

Simple Medical History
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Simple Medical History

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.

Pregnancy Verification
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Pregnancy Verification

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.

Medical Invoice
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Medical Invoice

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

Online Therapy Consent
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Online Therapy Consent

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.

Vaccination Record Card
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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.

Short Medical History
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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.

Release of Information
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Release of Information

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
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Professional Medical Release

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

Client Progress Report
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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.

Insurance Waiver
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Insurance Waiver

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

Medical Records Release Authorization
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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.

COVID-19 Vaccine Administration Record
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COVID-19 Vaccine Administration Record

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

Summer Camp Parental Consent
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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.

Dental Health Record
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Dental Health Record

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
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Patient Progress Report

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.

Professional Medical History
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Professional Medical History

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.

First Aid Incident Report
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First Aid Incident Report

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. Plus, Jotform is HIPAA-compliant and that is gigantic in addition to for anybody in the medicinal services industry.

Professional Physical Therapy Consent
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Professional Physical Therapy Consent

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

Doctors Excuse
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Doctors Excuse

Use this Doctors Excuse Template in order to create a document that you'll give to the patient after a medical check-up. This PDF template is normally needed by individuals who need more rest and not come to work.

HIPAA Release Form
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HIPAA Release Form

HIPAA (Health Insurance Portability and Accountability Act), also known as Public Law 104-191, is a law passed in the United States that protects and safeguards the privacy of medical information and has two main purposes: First, to provide continuous health insurance coverage to workers who switch jobs or lose their jobs; Second, is to standardize the electronic transmission and transactions for security and protection of information. This law was primarily passed due to proliferation of data breaches concerning health information.This HIPAA Release Form PDF Template is a standard release authorization form for disclosure of health information for healthcare and health insurance providers which the subject or person consents on disclosing his health information to a certain healthcare organization. This HIPAA Release Form PDF Template is easy to modify and flexible to use.

Personal Medical History
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Personal Medical History

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.

Child Medical History
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Child Medical History

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.