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 Consent Form for Child

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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.
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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.
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PHQ-9 Modified for Teens

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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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Grief Evaluation for Children & Teenagers (17 and Under)

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Medical Intake Form Template

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.

Streamline patient forms and engagement

Collect forms. Engage patients. Automate follow-up.

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

Sync Submissions to Google Drive

When you receive a patient form submission, automatically send the submission directly to your Google Drive folder.

Conditional Logic

Conditional Logic Forms

Only show information that is relevant to the patient with conditional logic forms. Make it simple for your patients to complete your forms and improve the accuracy of the data you receive with conditional logic.

HIPAA Compliant Submission Audit Logs

Submission Audit Logs

Form submissions have a detailed history that can always be referenced. Audit logs cannot be changed and the history from all users is tracked.

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Export Form Submissions to Excel

Export multiple patient forms into a Microsoft Excel compatible CSV file. Take control of your patient data with a bulk export, and import your complete patient forms into a database, excel spreadsheet, or EHR.

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