Health Care Proxy Form
A health care proxy form is an official document that designates a third party to be responsible for a person’s health when that person can no longer make decisions for themselves — be it temporary or permanent. Build a professional, HIPAA-friendly Health Care Proxy Form that works for your needs with Jotform Sign. Create, customize, and send in just a few clicks.
Ensure that your Health Care Proxy Form meets all your specific needs by personalizing it with our easy-to-use form builder. Drag and drop to upload certificates and images, create an automated signing order, make cosmetic changes to colors and fonts, and more. Once you’re finished designing, simply send and wait for confirmation e-signatures. Then all parties involved will receive a copy for their records.
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.
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.
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.
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.
Background Check Template
Create a custom background check form for your business. Converts into PDF. Easy to share and embed. Works on any device. Android and iOS compatible. No coding.
Hospital Discharge Template
The Hospital Discharge Template is a detailed document that provides patients with instructions and information upon discharge from a healthcare facility
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.