Medical Intake Form Template

Easily send and receive your medical intake form online. Send patients your intake form to fill out on their phone, tablet, or computer. Patients securely sign and submit completed forms directly to your account. Track the progress of intake forms, send automated reminders, and receive completed medical intake forms online.
Medical Intake Form

Medical Intake Form Template

Give patients the freedom to complete medical intake forms with any device, anywhere. Streamline the way you collect intake forms by setting up your forms online. 

Easily personalize this medical intake form template with a HIPAA compliant form builder.

Streamline patient forms and intake

Collect forms. Engage patients. Automate follow-up.

What is a Medical Intake Form?

Medical intake forms collect demographic, health history, consent forms, insurance, and other important pieces of information from new and returning patients, prior to their visit.

Medical intake forms collect everything from patients’ addresses, phone numbers and email addresses, medical and social history. Adding an option for patients to upload their insurance cards before the appointment gives you the ability to verify this information, and keep it on file for future appointments.

The medical intake process is often times the first experience the patient has with your practice, and places a critical role in the success of your business. A streamlined medical intake process means shorter wait times for patients, and improves operational efficiency. Gathering clinical data during the intake process means your providers can improve the quality of care and improves your patient satisfaction.

A refined medical intake forms offers the ability to set the tone for your patient’s experience and gives you an opportunity to interact with your patients before stepping foot in your office. By having a high-quality medical intake form, you are communicating to your patient that the level of service you offer is equally as high.

More Online Medical Forms

Streamline your medical forms online. Automate your paperwork. Start saving time and money.
Advanced Beneficiary Notice Form Template

Advance Beneficiary Notice of Noncoverage

Easily keep your patients informed, while fulfilling Medicare requirements by sending this form when you suspect an item may not be covered under Medicare. Keeping your patients informed empowers them with the information to make the best health and financial decisions.
Medical Consent Form for Child

Medical Consent Form for Child

Have parents and guardians electronically sign medical consent forms for children. Parents and guardians can easily sign HIPAA compliant online forms with their phone, tablet, or computer.
Patient Health Questionnaire (PHQ-9)

Patient Health Questionnaire (PHQ-9)

Give your patients the freedom to complete the PHQ-9 from any device, anywhere. Ensure privacy and help keep teens safe by ensuring completion of this screening form before their clinic visit.
Grief Evaluation for Children & Teenagers (17 and Under)

Grief Evaluation for Children & Teenagers (17 and Under)

Collect valuable information concerning your patient’s grief experience and daily life. Review this information prior to the appointment to guide the conversation.
Insurance Form Template

Insurance Form

Use the Insurance Form to gather all of the necessary pieces if information to contact, obtain pre-authorization, and bill patient insurance plans. Customization and required fields makes records complete the first time.
Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist

Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist

Give patients the freedom to complete the adult ADHD self-report checklist at the most comfortable an convenient time, with a phone, tablet, or computer. Information is submitted securely and is ready for your review before the appointment.
Privacy Practices Form Template

Notice of Privacy Practices

Easily comply with the HIPAA Privacy Rule by providing your patients with an electronic privacy notice to read and complete before the initial visit. The notice can be read when convenient, signed and then returned for an informed, efficient clinic visit.
Patient Satisfaction Survey

Patient Satisfaction Survey

Follow up with your patients by sending this patient satisfaction survey. Your patients are your customers and patient satisfaction is critical to ensuring the success of your practice.

Streamline patient forms and engagement

Collect forms. Engage patients. Automate follow-up.

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
Autocomplete populating patient information across multiple forms

Autocomplete Forms

Have your patient enter information once and have it autocomplete throughout your medical form online. Automatically populate PHI directly into additional fields and medical consent forms.

Required form fields preventing submission of an incomplete patient form

Required Form Fields

Always get the information you need with required fields. Patients can only submit when they complete all of your required fields. Never receive an incomplete medical form again.

Multiple patient forms combined into a single online intake packet

Intake Form Packets

Combine multiple pages into an online form packet. Have your patients fill out their medical history, consent to treat, and demographics all in one new patient intake form packet.

HIPAA Compliant Electronic Signatures

HIPAA Compliant Electronic Signatures

Collect electronic patient signatures before the appointment. Easily give your patients the ability to digitally sign from their phone, tablet, or computer.

Book a Free Demo

Schedule a demo to see how FormDoctor can streamline patient forms and automate engagement.

FormDoctor gives your practice one HIPAA-compliant platform to collect forms, communicate with patients, and automate follow-up. We help practices who:

  • Are still using paper forms, PDFs, or Word documents
  • Spend too much time printing, scanning, emailing, and calling patients
  • Need an easier way to send reminders and automate follow-ups
  • Want to streamline forms, communication, and paper workflows