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Free Online Medical History Form Templates
A medical history form is an online document that collects the necessary information about a patient before diagnosing and treating their illness. Questions such as the patient's age, weight, height, and past illnesses are usually asked in form fields. Therefore, it is a form clearly needed in every health institution to ensure a smooth intake process.
41 templates are listed in this category
Medical History Form
The traditional way of getting a patient's medical history is by having them fill out a form in your office. This process can be time-consuming and inconvenient for both you and the patient. Use an online medical history form template instead! With forms.app, you can create a custom form in minutes. Plus, you will be able to add or remove questions easily and effortlessly.
HIPAA Medical History Form
A HIPAA medical history form is an essential tool for healthcare providers to securely collect and store patients' health information. This template ensures compliance with HIPAA regulations, safeguarding sensitive medical data while streamlining the patient intake process. Get started with this free template today!
Medical Intake Form
The medical intake form is a critical document that helps the healthcare provider to get a complete picture of the patient's condition. It is used to determine the best course of treatment for the individual. On forms.app, you can easily select this medical intake form template and create your custom form in minutes.
Patient Intake Form
This template helps healthcare providers collect and maintain a record of patients' personal, medical, and insurance information. This free online patient intake form offers three main benefits for healthcare providers:
Botulinum Toxin Medical History Form
Digital forms help you prepare for a safe and efficient botulinum toxin treatment process. A botulinum toxin medical history form is an essential document to gather critical patient health information before administering any procedures. Get started now with this free and customizable template!
New Patient Enrollment Form
If you own a private clinic or hospital, you may use online forms to strengthen your communication with your patients. One of these forms is the new patient enrollment form which helps with the data collection process. Start today with the new patient enrollment form template below!
Immunization Record Request Form
With the immunization record request form, doctors, nurses, and healthcare professionals, in short, can keep an electronic record of your patients' immunization. You can easily access the immunization request records. You can customize the form as you see fit.
Medicare Enrollment Form
Processes such as creating a new patient record or obtaining information about your patient's medical history are now even easier with online medicare form templates. Communication between the healthcare professional and the patient must be maintained to understand the patient better. This form builder has various templates for healthcare institutions and individuals to strengthen patient relationships.
Medical Record Audit Form
Healthcare professionals must keep accurate and complete medical records in order to provide effective healthcare. Therefore, with the help of an online form, you can not only keep all records accurately at hand but also make your work more practical. Use our free medical record audit form template to create your online form more easily!
Request to Obtain a Copy of Clinical Record Form
Patients or beneficiaries can request a copy of their medical records from a healthcare organization. Hospitals and clinics can use this request form to gather document requests from people who receive medical care and request a copy of their medical records.
Pet Health Record Form
Do you want to keep track of pets' information in a more organized way? By using the Pet health record form template, you can keep the important information about pets together without even adding questions. You can get started quickly using forms.app!
Medical Records Request Form
If you want to collect requests from patients, you can easily do so with an online form. Luckily, forms.app allows you to create your own medical records request form based on your team’s needs. You may quickly get started by clicking the “Use Template” button if you do not want to waste any time searching for a suitable form.
Request to Inspect a Copy of Clinical Record Form
Check out this request to inspect a copy of clinical record form template to quickly create your form and collect requests online for free. You can create your request to inspect a copy of clinical record form in minutes with no coding. To start now, click the ‘’Use Template’’ button.
Weight Tracker Form
A weight tracker form helps individuals or health coaches monitor weight changes over time for fitness, wellness, or medical goals. With this easy-to-use and customizable template from forms.app, you can log and visualize your progress with clarity. Click “Use Template” to start tracking today!
Botulinum Toxin Treatment Record Form
A botulinum toxin treatment record form helps clinics and practitioners document patient information, dosage, and injection sites for each treatment session. This customizable template from forms.app supports accurate tracking, patient safety, and compliance with medical standards. Click “Use Template” to get started now!
Mental Health Intake Form
The mental health intake form is a document that captures the details of an individual's experience with their mental health. By using an online form, you can gather the necessary information in a standardized way before consulting with the patient. This mental health intake form template was created to help clinicians streamline the data collecting process and worm more efficiently.
Permission to Treat Form
A growing number of private clinics are now using online permission to treat forms in order to streamline the process of obtaining consent from patients. These forms allow patients to provide their consent for treatment through an online form, which can then be processed by the clinic. This system eliminates the need for paper forms and allows clinics to easily track patient consent.
Chiropractic Intake Form
A chiropractic intake form is a document used by chiropractors to gather important information about a patient's health history, current symptoms, and treatment preferences. If you are creating a chiropractic intake form, you need to follow some essential steps, and avoid at the same time.
Pet Insurance Claim Form
Pet insurance reimburses insured veterinary expenses related to a pet's medical event or care. As an insurance company, you can use the pet insurance claim form to gather claims for your organization or agency easily. Create your form for free today using forms.app to complete pet insurance transactions quickly and reliably!
Child Health Survey
Child health surveys are used to collect important information about the health and well-being of children in the community. Use this free survey template to understand children's needs and identify ways to support their physical and mental development, and create your professional health survey!
Children’s Nutrition Questionnaire
Assessing children's dietary intake and nutritional status allows you to prevent future health problems. Create your children’s nutrition questionnaire using this free template and identify possible nutritional problems in the child's diet. Customize the template as you wish and create your professional questionnaire!
Depression Questionnaire
Depression is a health and mental state condition with numerous types and can be hidden for a long time. So it may be necessary to use methods, like online surveys, to detect it. Create your free questionnaire with the depression questionnaire template today to identify your patient's condition!
Health Survey
Use a health survey to collect data about the general health status of a population or group and analyze the results. Create your survey in minutes with this free, customizable health survey template!
Wellness Evaluation Form
This wellness evaluation form assesses a person's physical and mental health. A wellness evaluation form aims to help professionals determine an individual's overall health. You can easily obtain this form and customize it for your goals. Get started by clicking the “Use Template” button now!
Stress Management Questionnaire
A stress management questionnaire is a way to measure a person's stress level. Usually, mental health professionals use it to ask a set of questions related to stress and how individuals respond to these stressful situations. Use this stress management questionnaire template to create your survey today.
Beck Depression Inventory Questionnaire
The beck depression inventory is a widely used test to assess the presence and severity of symptoms of depression. With forms.app's free beck depression inventory questionnaire, you can take the first step towards overcoming the effects of depression. Start using this online questionnaire to measure symptoms of depression today!
Center for Epidemiologic Studies Depression Scale Form
Center for epidemiologic studies depression scale is a way of measuring depression for mental health professionals. It consists of 20 self-report items that measure sadness, fatigue, sleep, appetite, and concentration. It has been evaluated on various groups consisting of different cultural and gender backgrounds, and it can also be used for age groups starting from 6 to older adults.
Wellness Questionnaire
The wellness questionnaire is a way of assessing individuals' overall health and well-being that can be used by healthcare providers and employers who want to assess the wellness of newly hired employees. By gathering these types of data, you can create awareness of individuals' health, and you can take action before anything serious happens.
Psychiatric Evaluation Form
If you are a mental health professional, you can use this free psychiatric evaluation form to get a psychiatric evaluation of your patients. You can customize this ready-made psychiatric evaluation form, change or add questions, and create your own evaluation form on forms.app in just a few minutes.
Psychological Assessment Form
Collecting psychological assessments might seem time-consuming; however, a psychological assessment form template is the solution for this problem. A well-designed psychological assessment form help:How to use free medical history form templates
Follow the three easy steps below to import the template into your account, customize the questions, and quickly share the quiz on your website or social media.
2. Customize as you like
Add or remove questions through forms.app's drag-and-drop interface and match your brand style.
3. Share it on all channels
Embed it on your website in 6 different ways or share your form across all social media channels.
Need a custom medical history form?
Just tell us how you would like a custom medical history form tailored to your specific needs. forms.app’s free AI form builder will create a custom form template for you in seconds.
About the medical history forms
Medical history forms are digital documents used to collect a patient’s information about past and current health. They typically include details about medical conditions, surgeries, medications, allergies, family health history, and other factors. Healthcare providers use these forms to understand patients better, ensure safe treatment, and reduce risks.
Every template you choose on this page already comes with specific fields. These common fields include the following:
- Multiple-choice fields: To select symptoms and conditions.
- Open-ended fields: To explain medical history details.
- File upload fields: To share reports or test results.
- Date & time fields: To record visit or diagnosis dates.
- Contact fields: To collect patient contact information such as phone number, emergency contact, etc.
- Legal fields: To obtain consent and signatures.
- Rating scales: To assess pain or discomfort levels.
Who are these medical history form examples for?
Medical history form examples can be used by various professional groups for a range of purposes. Here are groups that use online medical history forms to collect vital feedback about patients’ health conditions, patients’ experience, chronic conditions, lifestyle factors, and more.
Hospitals and clinics
Hospitals and clinics collect comprehensive patient data before appointments to improve diagnosis accuracy and treatment safety.
Private medical practices
Private medical practices gather patient intake in a health background to save time, reduce paperwork, and ease consultations.
Dental clinics
Dental clinics record dental history, allergies, medications, and surgical history before treatments.
Mental health professionals
Mental health professionals collect psychological history, medications, and therapy background to prepare effective treatment plans.
Physiotherapy centers
Physiotherapy centers understand past injuries, surgeries, and pain levels to design safe and customized rehabilitation programs.
Medical laboratories
Medical laboratories obtain relevant health details to ensure accurate testing procedures and reliable diagnostic results.
Rehabilitation centers
Rehabilitation centers track long-term medical conditions and recovery progress to support continuous patient care.
Occupational health providers
Occupational health providers assess employees' medical histories to determine workplace fitness and to meet health and safety regulations.
What information is typically included in a digital medical history form?
A digital medical history form typically includes personal and contact details, current and past medical conditions, medications, allergies, surgeries, family health history, and lifestyle information. It may also include consent, signatures, and file uploads for medical reports.
Can I customize the form for my practice?
Yes, you can fully customize the form for your specific use case. With forms.app, you can add or remove questions, choose suitable form fields, apply your branding, and adjust the layout to match your style and needs.
FAQs
Are the forms mobile-friendly?
Yes, all templates on forms.app are optimized for all devices, whether it’s desktop, tablet, or mobile.
Can I use these forms for different specialties?
Yes, these forms can be used for different medical specialties. With forms.app, you can easily tailor questions, fields, and layouts to fit general practice, dental care, mental health, physiotherapy, and many other specialties.
Are these templates legally binding?
Medical history forms are legally binding only if they include an electronic signature field and comply with applicable laws (such as the IRB application). Electronic signatures can be legally binding if they meet certain conditions, such as identifying the signer and proving that they have access to the private key used.
Are these medical history form templates safe?
Yes! forms.app is designed with industry-leading strong security and privacy protections, which makes it quite safe for collecting user data and also payments. And what’s more, you retain control over your data, which means you can set form-access permissions.
● All forms and responses are encrypted and stored on Google Cloud storage service servers located in the EU.
● forms.app is GDPR compliant, which means it handles personal data according to strict EU privacy rules; holds ISO/IEC 27001, ISO/IEC 27701, PCI DSS security certifications; and meets the OWASP security standards.
● Servers are hardened, access is restricted, and Cloudflare is used to help protect against attacks like DDoS.
● There is real-time disaster recovery: your valuable data is backed up across multiple servers so it can be recovered in emergencies.
● Your account’s security is also strong: you can enable two-factor authentication, control who has access to your forms, and back up your data easily.
Can I collect signatures on these forms?
Yes! You can collect digital signatures and obtain agreement to your terms and conditions before they submit their forms. Click the "+" button within the form builder, select the "Signature" option, and simply drag and drop the signature field to the desired position on your form.
Can I use these forms across different channels?
Yes, you can use these forms across different channels. With forms.app, you can share your surveys via direct links, email, social media, QR codes, or embed them on your website. This flexibility allows you to collect responses wherever your audience is most active.
Do I need experience in research or analytics to use these templates?
No, you don’t need any prior experience in research or analytics. All templates on forms.app are designed to be beginner-friendly, with ready-made questions and a drag-and-drop builder. You can easily customize questions, collect responses, and review results without any technical or analytical background.