Medical Application Forms

109 Templates

Looking for a better way to gather medical staff application forms, reimbursement application forms, or health insurance application forms? Whether you’re managing a hospital or private practice, take your Medical Application Forms online with Jotform! Simply choose a form template below to rid yourself of messy paperwork and improve your intake process. Start by embedding your custom medical application form on your website, and watch as submissions are securely sent to your Jotform account — easy to view and manage on any device.

If you’d like to customize the look of your chosen medical form, don’t worry — Jotform Form Builder makes it easy to get the exact look you want. Add your company logo, change fonts and colors, or add a useful widget or integration to make your application process even more efficient. Why not integrate with a secure payment gateway like Stripe or PayPal to securely accept application fees online? Be sure to keep your data secure with HIPAA compliance features. — this is especially important for sensitive health information submitted for medical card applications, medical reimbursement applications, and medical insurance applications. Streamline your application process with a free, online Medical Application Form today!

Online Doctor Appointment Form

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

Healthcare Forms

Coronavirus Screening Form

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

Healthcare Forms

Blood Donation Form

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. Fully customizable and free.

Healthcare Forms

Organ Donation Registration Form

Signing up in a donor registry can be a daunting task. Help the donors to become a registrant by using this simple Organ Donation Registration Form which is very easy to use.

Medical Application Forms

Intake Form For Care Providers

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

Medical Application Forms

Teletherapy Consent Form

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

Medical Intake Form

A Medical Intake Form is a form template designed to collect comprehensive information about a patient's medical history, past surgeries, genetics, and symptoms

Healthcare Forms

HIPAA Medical History Form

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

Medical Insurance Application

A medical insurance application form is a form template designed to collect the necessary information to determine whether an individual is eligible for health insurance coverage

Healthcare Forms

Doctor Referral Form

Efficiently write your Doctor Referral form by directly providing the information in the form. Send your referrals instantly using this Doctor Referral Form.

Healthcare Forms

Patient Intake Form

Register new patients for your practice with a free online Patient Intake Form. Great for telemedicine or telehealth. Option for HIPAA friendly features.

Healthcare Forms

COVID 19 Client Health Questionnaire

The COVID-19 Client Health Questionnaire is a document that physicians and vaccine experts use to collect information from their clients. Just customize this template without coding!

Healthcare Forms

Reiki Intake Form

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.

Telehealth Forms

Dietitian Patient Questionnaire

Here is a Dietitian Patient Questionnaire that allows for new patient enrollment through collecting their personal and contact information with a detailed medical history and nutrition habits.

Medical Application Forms

Patient Extensive Intake Form

A patient extensive intake form is used by nursing or medical professionals to document patient information.

Healthcare Forms

Medical Insurance Verification Form Template

A Medical Insurance Verification Form Template is a form template designed to streamline the process of verifying coverage details and insurance eligibility for healthcare providers, hospitals, and medical clinics

Insurance Forms

Medical Staff Application Form

A Medical Staff Application Form is a form template designed to streamline the process of hiring medical staff and collecting essential information about new medical staff

Human Resources Forms

Chiropractic Intake Form

Check the needs of the patient by using this Chiropractic Intake Form. This will serve as a health record of the patient where the chiropractors can base on how they will proceed with the treatment.

Healthcare Forms

Waxing Consultation Form

A waxing consultation form is a form used by estheticians for collecting information regarding the needs of a customer that plans to get a wax treatment. Use this Waxing Consultation Form without coding!

Consultation Forms

Prescription Refill Form Template

Prescribe medication refill online by using this Prescription Refill Form Template. This form template can be easily accessed in any device like smart phones, tablets, and laptops.

Healthcare Forms

Pediatric Patient Intake Form

Here's a pediatric intake form to evaluate children's health needs. If you are a pediatrician, you can use this pediatric history template to connect with the children's parents or guardians quickly and easily, get valid answers about their child's health and a lot more information. Use this pediatric health history form template to provide comprehensive health care and a complete understanding of the patient’s physical, mental and emotional condition and history.

Healthcare Forms

Prior Authorization Form

A prior authorization form is a form used by medical professionals to confirm that a patient has pre-existing coverage for specific medications and medical procedures. Collect info with this free form!

Healthcare Forms

Patient Waiting List

Use this free Patient Waiting List template to sign up potential patients for their examinations and treatment.

Healthcare Forms

Patient Encounter Form Template

Monitor office visits with this free Patient Encounter Form. Easy to customize and fill out from any device. HIPAA compliance features. No coding required.

Healthcare Forms