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.

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.
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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HIPAA Authorization Form

Stay in compliance and make sure you have the correct HIPAA information on file for each patient. The electronic HIPAA Authorization form is customizable and an easy way for your patients to keep their information updated.
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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.
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.
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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.
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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.
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.

Setup your medical intake form for free

Start saving time and money with FormDr

Discover More Features

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

Embed Forms on Website

Embed Forms on Website

Embed your forms directly on your website for a seamless experience for your patients. Your forms are customized with your logo, brand, and styling to match your site. Embed on Wordpress, Wix, Squarespace, and many more.

Appointment Reminder

Patient Appointment Reminder

Schedule automatic reminders to your patients to complete your forms before their appointment. Get more completed forms online before the scheduled appointment.

HIPAA Compliant Form Builder

HIPAA Compliant Form Builder

Easily build HIPAA compliant online forms. No coding is required to create secure online intake forms for your patients. All patient form submissions are encrypted in transit and rest. A Business Associate Agreement is included with your service.

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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