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.

More Online Medical Forms

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

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.

Edinburgh Postnatal Depression Scale Form

Use this standardized screening checklist to identify postpartum depression symptoms and determine the severity of illness.
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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.
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.
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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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.

Setup your medical intake 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.
Custom Thank You Page

Custom Thank You Page

Create your own custom ‘Thank You’ page to direct patients to upon completion of your forms. Forward them along to the next steps of your intake process.

Email Invitation Forms

Email Invitations

Send an email invitation to your patients to complete your forms. Give patients the freedom to sign, complete, and submit forms with any device, anywhere.

HIPAA Compliant File Upload

File Attachment Upload

With file upload fields, your patients can upload their prescriptions, x-rays, medical records, insurance card photos and more with their form submission.

Export to Excel

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.

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Get started today with a template, or we can build your forms for you.

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