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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.
Setup a Medical History Form
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.

Setup a medical history form for free

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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.

More Online Medical Forms

Streamline your medical forms online. Automate your paperwork. Start saving time and money.

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.
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HIPAA Consent Form

Give your patients the freedom to complete HIPAA consent forms with any device, anywhere. Streamline the way you collect signatures and consent forms by setting up your form online.
cancellation-policy-

Cancellation Policy

Collect signed acknowledgements of the clinic cancellation policy online before the appointment. Informed patients provide better communication, which in turn reduces your clinic no-shows and late cancellations.
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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.
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HIPAA Authorization Form

Stay in compliance and make sure you have the correct HIPAA information on file for each patient. The electronic HIPAA Authorization form is customizable and an easy way for your patients to keep their information updated.
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.
Medical Release Form Template

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.
Patient Satisfcation Survey Template

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.

Setup a medical history form for free

Start saving time and money with FormDr

Discover More Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
HIPAA Compliant Tablet Forms

Forms on iPads or Tablets

Give patients the option to sign and complete forms online with an iPad or tablet. Online forms work on all tablets and iPads.

HIPAA Compliant Mass Messaging

Reach all of your patients quickly with Mass Messaging. Send promotions, updates, and appointment reminders in just a few clicks.

Appointment Reminder

Patient Appointment Reminder

Schedule automatic reminders to your patients to complete your forms before their appointment. Get more completed forms online before the scheduled appointment.

EHR & EMR Integration

Share patient data back and forth from FormDr to common EMR systems seamlessly with EHR Integrations.

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FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who:

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms