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

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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.

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 Intake Form Template

Patient Intake Form

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

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.
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.
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.
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.
phq9-form-template-icon

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.
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.

Setup a medical history form for free

Start saving time and money with FormDr

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
HIPAA Compliant Form Submissions

HIPAA Compliant Form Submissions

Patients sign and submit forms securely to your online account. Review and manage completed patient forms before the appointment.

Required HIPAA Compliant Form Fields

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.

Print HIPAA Compliant Submissions

Print HIPAA Compliant Form Submissions

Print your patients’ submissions after the forms have been completed online. Adjust the formatting and text size to match your original paper forms.

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.

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