Medical Intake Form Template

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

Medical Intake Form Template

Give patients the freedom to complete medical intake forms with any device, anywhere. Streamline the way you collect intake forms by setting up your forms online. 

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

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What is a Medical Intake Form?

Medical intake forms collect demographic, health history, consent forms, insurance, and other important pieces of information from new and returning patients, prior to their visit.

Medical intake forms collect everything from patients’ addresses, phone numbers and email addresses, medical and social history. Adding an option for patients to upload their insurance cards before the appointment gives you the ability to verify this information, and keep it on file for future appointments.

The medical intake process is often times the first experience the patient has with your practice, and places a critical role in the success of your business. A streamlined medical intake process means shorter wait times for patients, and improves operational efficiency. Gathering clinical data during the intake process means your providers can improve the quality of care and improves your patient satisfaction.

A refined medical intake forms offers the ability to set the tone for your patient’s experience and gives you an opportunity to interact with your patients before stepping foot in your office. By having a high-quality medical intake form, you are communicating to your patient that the level of service you offer is equally as high.

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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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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.
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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 your medical intake form for free

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Discover More Features

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

HIPAA Compliant Mass Messaging

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

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.

Centralized Inbox

Centralized Inbox

Streamline communication with a Centralized Inbox, bringing all patient messages, form submissions, appointment requests, and follow-ups into one organized platform. Improve efficiency and responsiveness by managing all conversations in a single, easy-to-use hub.

Encrypted HIPAA Compliant Forms

Encrypted HIPAA Compliant Forms

Your forms are protected with a 128-bit secure socket layer which encrypts your patient’s data. Securely collect patient forms online with HIPAA compliant online forms.

Book a Free Consultation

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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