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

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.
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.
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.
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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.

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.
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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.

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.
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.

HIPAA Compliant Online Intake Form Packets

Intake Form Packets

Combine multiple pages into an online form packet. Have your patients fill out their medical history, consent to treat, and demographics all in one new patient intake form packet.

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.

Autocomplete HIPAA Compliant Forms

Autocomplete Forms

Have your patient enter information once and have it autocomplete throughout your medical form online. Automatically populate PHI directly into additional fields and medical consent forms.

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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