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.

Setup a medical history form for free

Start saving time and money with FormDr

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.
Medical Consent Form Template

Medical Consent Form

Easily have patients complete your medical consent form with their phone, tablet, or computer. Make it easy for patients to complete your consent forms online.
Telemedicine Consent Form Template

Telemedicine Consent Form

Easily have patients complete your HIPAA compliant telemedicine consent form with their phone, tablet, or computer. Make it easy for patients to complete your consent forms online.
phq9-teen-form-template

PHQ-9 Modified for Teens

Give your teen 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.
adhd-self-report-form-template

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.
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.
grief-evaluation-form-template

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.
COVID-19 Screening Form Template

COVID-19 Screening Form

Send patients COVID-19 screening forms to fill out on their phone, tablet, or computer. Safely screen patients for COVID-19 by enabling them to fill out forms on their own device.
insurance form template icon

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.

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.
User Management

Interoperability

FormDr provides interoperability and customization solutions for every need, including Open API and select EMR / EHR integrations.

Reporting

Custom Reporting

Monitor text messaging effectiveness to see patient response rates, track appointment scheduling trends to reduce no-shows, and analyze phone call data for improved communication. Gain insights into your opportunity pipeline to identify potential patients and increase conversions, while leveraging mass messaging analytics to measure outreach success.

Resend HIPAA Compliant Forms

Resend HIPAA Compliant Forms

Resend completed patient intake forms. Patients will simply update what has changed, and leave the rest of the form completed.

HIPAA Compliant Form Kiosk

Kiosk Form Page

Configure a HIPAA compliant form kiosk page to display new patient registration forms, consent forms, and more.

Book a Free Consultation

Schedule a consultation with us to learn more

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