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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
Child Care Observation Form
Would you like to follow your children's development in a more organized way? By using the questions in the child care observation form template, childcare providers can provide families with more information about children. Create your own form without the need for coding knowledge by registering on forms.app!
Sleeping Habits Survey
Would you like to learn the sleep habits of your patients faster? Thanks to the questions in the sleeping habits survey template, you can collect information about your patient's sleep habits before they come to you for treatment. Use forms.app to create surveys in seconds; no code is required!
Sleep Deprivation Survey
Do you know how sleep deprivation can cause problems in a person's life? You can understand whether you have a sleep problem by using the questions in the sleep deprivation survey template. Register on forms.app now to create customized surveys!
Dreams & Nightmares Survey
Do you want to see what effect dreams and nightmares have on people? With the dreams & nightmares survey template, you can find out what kind of visions people see in their daily lives and their effects. Register on forms.app to create your own form now!
Sleeping Disorders Survey
Do you want to dig deeper into the causes of sleep disorders? Thanks to the questions in the sleeping disorders survey template, you can get information about people's sleep disorders. If you want to create your own survey without any coding knowledge, use forms.app now!
Cosmetic Surgery Survey
As a cosmetic surgery center owner, you can quickly get comments and information from the patients with this free cosmetic surgery survey template. All you have to do is change the questions in the ready-made form and add new questions. Click the āāUse Templateāā button and start using it.
Online Medical Questionnaire
This free online medical questionnaire template allows potential patients to flag their symptoms or talk about disease symptoms. The online medical questionnaire makes the process easier by giving the patient a list of likely symptoms. Just click the āUse Templateā button to get started.
Patient Exit Survey
As a healthcare provider, it is essential to collect general information from your patients. You can easily administer this free patient exit survey template to your patients at your medical institutions. All you have to do is click the āāUse Templateāā button and start creating your own survey.
Health Checklist Form
A health checklist form is a curial template primarily used for tracking, monitoring, and checking oneās health. This kind of checklist improves physical health for everyone, whether you are a medical professional, a healthcare provider, or a regular person. Just click the āUse Templateā and start using it!
Sports Player Profile Form
As a sports coach, use this sports player profile form to gather players' personal details and medical history. You can edit this free sports player profile form with many themes and edit its questions depending on your needs. All you have to do is click the āUse Templateā button.
Request to Amend Protected Health Information
Make your gathering data process easy with forms.app. Open this request to amend the protected health information template and quickly collect the patient documents and information. Share it online by choosing one of the various options and track your outcomes. Click the āUse Templateā button and start creating your form.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.appās 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 patientās 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 patientsā health conditions, patientsā 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 itās 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 whatās more, you retain control over your data, which means you can set form-access permissions.
ā All forms and responses are encrypted and stored on Google Cloud storage service servers located in the EU.
ā forms.app is GDPR compliant, which means it handles personal data according to strict EU privacy rules; holds ISO/IECāÆ27001, ISO/IECāÆ27701, PCI DSS security certifications; and meets the OWASP security standards.
ā Servers are hardened, access is restricted, and Cloudflare is used to help protect against attacks like DDoS.
ā There is real-time disaster recovery: your valuable data is backed up across multiple servers so it can be recovered in emergencies.
ā Your accountās 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 donāt 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.