Patient Intake Form

The Patient Intake Form helps you collect important details from new patients.

This form asks about their medical history and current health concerns.

By using this form, you can better understand what your patients need. This makes it easier to provide the best care possible.

It’s great for doctors, clinics, and hospitals that want to make sure every patient gets the attention they deserve.

About this template

A Patient Intake Form is an essential part of any healthcare facility, helping you collect important information from patients before their visit. With Formester’s Form Builder, you can quickly create a professional and customized Patient Intake Form to ensure a smooth experience for both staff and patients.

Formester provides a range of Free Form Templates that can be tailored to your practice’s needs. You can add fields for personal details, medical history, current medications, allergies, insurance information, and emergency contacts. This ensures that you gather all the necessary information to provide the best care for your patients.

One of Formester’s standout features is Conditional Logic, which allows you to show different questions based on a patient’s responses. For example, if a patient indicates that they have a pre-existing condition, the form can automatically ask more specific follow-up questions to capture important details.

To make things even more efficient, Formester supports Electronic Signature for consent and authorization, allowing patients to sign documents digitally. This helps speed up the process and eliminates the need for paper forms.

Once the form is completed, Autoresponder Emails can be set up to automatically send confirmation emails to patients, acknowledging their submission and providing important details about their upcoming appointment.

Formester also allows you to Embed Forms on your website or share them via a link, making it easy for patients to fill out the form before they even step into your office.

Finally, Formester’s Form Analytics can give you insights into submission trends, helping you track patient intake data and ensure that the process is running smoothly.

With Formester, creating a Patient Intake Form is quick, easy, and fully customizable, making the intake process more efficient for both your patients and your team.

Looking for more templates?

Simplify your form creation process with our range of professionally designed form templates. Choose from a variety of styles and designs, including contact forms, surveys, job applications, and more - all available now for free!

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