Medical History Form Template

Easily send and receive your medical history form online. Send patients your medical history form to fill out on their phone, tablet, or computer. Patients securely sign and submit completed forms directly to your account. Track your patient's progress, send automated reminders, and receive completed medical history forms online.
Medical History Form Template

Medical History Form Template

Give your patients the freedom to complete medical history forms with any device, anywhere. Streamline the way you collect signatures and health history forms by setting up your form online. 

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

Streamline patient forms and engagement

Collect forms. Engage patients. Automate follow-up.

What is the Medical History Form?

A medical history form is used to disclose a patient’s past medical details to healthcare providers, physicians, and dentists.

The purpose of the medical history form is to show the physician important information regarding the patient’s health. The information entered on this form will determine care requirements and the risk factors for that patient. Medical history forms can vary depending on the physician’s treatments, and therapists have forms with extensive questioning on psychiatric health issues.

It is also important to include medical history milestones including; surgeries, tests or treatments, that the patient may have received. Collect accurate dates of these events and any details that the patient is able to provide with the medical history form.

The history form can easily be the largest form that is given to the patient. These forms are best sent to patients before the appointment, so they may have more time to fill out and not feel pressured to complete during their visit. Send medical health history forms online and give your patients the freedom to complete your form with any device, anywhere.

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Medical History Form Template

Medical History Form

Turn your paper medical history forms into HIPAA compliant online forms. Streamline your forms by removing the paperwork. Collect a more accurate medical history from your patients.
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Medical Intake Form

Easily have patients complete your medical intake forms online. Completed medical intake forms are submitted securely to your account, before the patient's appointment.
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Medical Release Form

Turn your paper medical history forms into HIPAA compliant online forms. Streamline your forms by removing the paperwork. Collect a more accurate medical history from your patients.

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.
Automated Bulk Export

SFTP Automated Bulk Export

Generate a bulk export of patient submissions that will be saved as a CSV Excel file. Select your frequency, time of day to export, and which forms you would like to export submissions from.

HIPAA Compliant File Upload

File Attachment Upload

With file upload fields, your patients can upload their prescriptions, x-rays, medical records, insurance card photos and more with their form submission.

Mobile Friendly Forms

Mobile-Friendly Forms

Easily build fully-responsive medical forms online that allow your patients to sign and submit on any device, anywhere, at any time.

HIPAA Compliant Form Builder

HIPAA Compliant Form Builder

Easily build HIPAA compliant online forms. No coding is required to create secure online intake forms for your patients. All patient form submissions are encrypted in transit and rest. A Business Associate Agreement is included with your service.

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