A telemedicine appointment form is used to schedule virtual appointments with doctors and medical consultants online. If you’re offering telemedicine services, our free Telemedicine Appointment Form will make it easier for patients to request appointments online while helping you stay organized. Simply customize the form to meet your needs and embed it on your website or share it with patients via email to start accepting requests for appointments. Patients can enter their personal information, select what services they’d like, and describe their medical history and health insurance. You’ll receive submissions in your secure Jotform account, protected by HIPAA compliance features with an appropriate plan.
This Telemedicine Appointment Form is formatted for mental health professionals offering counseling and therapy, but if you work in another department and offer different services, just use our drag-and-drop Form Builder to modify the template. It’s easy to add more form fields, terms and conditions, and a dropdown calendar that lets patients select appointment times and dates. You can also integrate the form with your favorite apps to instantly sync submissions to those accounts — try sending patient information to your cloud storage account or healthcare CRM, or automatically adding appointments to Google Calendar. With a Telemedicine Appointment Form, you’ll simplify the booking process for patients and be able to respond to patients in need of treatment, all while keeping a safe distance.