Medical Intake Form Templates

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

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 secure form builder.

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What is a Medical Intake Form?

Medical intake forms collect demographic, health history, consent, medications, 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 to medical and social history. Adding an option for patients to upload their identification or documents before an appointment gives you the ability to verify this information, and keep it on file for future appointments.

The medical intake process is often the first experience a 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 form offers the ability to set the tone for your patient’s experience and gives you an opportunity to interact with your patients before entering 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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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.
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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.
Patient Satisfcation Survey Template

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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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.
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AIMS (Abnormal Involuntary Movement Scale)

Setup an AIMS Form for free. Allow your clinicians to complete an Abnormal Involuntary Movement Scale Form safely and securely, online.
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Telemedicine Consent Form

Easily have patients complete your secure telemedicine consent form with their phone, tablet, or computer. Make it easy for patients to complete your consent forms online.
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ASQ Form Templates

Easily send and receive your ASQ form template online. Send patients forms to fill out on their phone, tablet, or computer at any time.
Medical Release Form Template

Medical Release Form

Turn your paper medical history forms into secure 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

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Discover More Form Features

Setup secure online forms. Streamline your process of collecting information.
HIPAA Compliant Electronic Signatures

Electronic Signatures

Easily collect electronic signatures from customers, clients, and patients. Anyone can digitally sign from their phone, tablet, or computer.

Mobile Friendly Forms

Mobile-Friendly Forms

Build fully-responsive online forms that allow your customers, clients, and patients to sign and submit on any device, anywhere, at any time.

HIPAA Compliant Tablet Forms

Forms on iPads or Tablets

Give customers, clients, or patients the option to sign and complete online forms with an iPad or tablet. Online forms work on all tablets, regardless of operating system.

HIPAA Compliant File Upload

File Attachment Upload

With file upload fields, your customers, clients, or patients can easily upload documents, pictures, and other items with their online form.

Schedule a consultation with us to learn more

FormDr gives you everything you need to easily send and receive Secure GPDR compliant forms and documents. We help businesses and practices that:

  • Are having customers, clients, or patients fill out paper forms
  • Are emailing customers a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms