Medical Forms & Templates
Jump-start your form design with a professional medical form template from Jotform. They’re fully customizable and easy to edit!
Please follow the HIPAA rules to ensure that your handling of personal health information complies with HIPAA.
Healthcare Form Templates
Our collection of online healthcare form templates makes it easier to register new patients and learn about their medical history. Jotform’s online form builder provides healthcare practitioners with an array of widgets, applications, and themes to enhance patient engagement — enabling better communication between patient and provider to better understand patients and their needs.
Get started by choosing one of our healthcare templates or start customizing your own. Additionally, Jotform offers a simple way to update medical history, acquire consent e-signatures, collect bill payments, find new business, and more. Jotform also offers HIPAA compliance features so your healthcare forms stay secure.
Coronavirus Self Declaration Form
Employees can complete this form online and report any COVID-19 symptoms they may have. No coding is required. HIPAA compliance option.
Screening Checklist For Visitors And Employees
Prevent the spread of COVID-19 with a free Screening Checklist for Visitors and Employees. Ideal for hospitals or other organizations staying open during the crisis.
Coronavirus Case Report Template
People can report suspected cases of COVID-19 in their workplace or community. Easy to customize, integrate, and share online. No coding required.
Group Therapy Informed Consent Form
A Group Therapy Informed Consent Form is a consent-collection document used by therapists or facilitators in informing their potential clients about the kind of services they provide.
Counseling Intake Form
The Counseling Intake Form allows for an easier client registration process as it automates gathering information from your clients, reduces paperwork and helps to keep patient records in a systematic way.
Coronavirus Self Assessment Form
Stay on top of COVID-19 prevention with a free online Coronavirus Self-Assessment Form. Send to patients who may have the virus. Collect data from any device.
Mental Health Intake Form
Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.
Teletherapy Consent Form
Collect informed patient consent and e-signatures online with a free Teletherapy Consent Form. Great for remote medical services. Get HIPAA compliance today.
Telehealth Consent Form
Get informed consent from patients online. Collect electronic signatures. Easy to customize for your practice.
Life Coach Intake Form
A Life Coach Intake Form is a form template designed to streamline the coaching process for life coaches.
Telemedicine Consent Form
Get consenting e-signatures online from your patients. Add terms and conditions without coding.
Doctor Referral Form
Efficiently write your Doctor Referral form by directly providing the information in the form. Send your referrals instantly using this Doctor Referral Form.
Psychology Informed Consent Form
A Psychology Informed Consent Form is a form template designed to acquire the consent of a person for a researcher or doctor's psychological study or treatment purposes.
Mental Health Assessment Form
Determine the mental state of an individual by performing a mental health exam using this Mental Health Assessment Form. This form is effective in diagnosing mental health status.
Medical Examination Report Form
A Medical Examination Report Form is a document required to complete by an individual in order to qualify for a new job or maintain their current job.
Caregiver Consent Form
Collect informed consent and e-signatures from parents with this free online Cargiver Consent Form. Ideal for healthcare organizations. HIPAA compliance option.
Guest Self Declaration Form COVID 19
Self Declaration form for Hotels or Other Businesses with required necessary details as directed by MoHA, CDC and WHO.
COVID 19 Client Health Questionnaire
The COVID-19 Client Health Questionnaire is a document that physicians and vaccine experts use to collect information from their clients. Just customize this template without coding!
Reiki Intake Form
Collect client contact info and e-signatures online with a free Reiki Intake Form. Easy to customize, embed, and fill out on any device. Sync with 100+ apps.
Medication Error Report Form
Report an incident to the appropriate authority where there's an error in providing medicine to the patient by using the Medication Error Report Form. Embed this form to your webpage or share it using the direct link.
Physician Referral Form
Refer patients to other physicians and collect referrals online. Easy to customize and embed. Integrate with 100+ apps. HIPAA friendly features option. No coding.
Testing Appointment Form
Schedule appointments for suspected patients of coronavirus and other diseases. Easy to customize, integrate, and embed. No coding.
Virtual Care Appointment Form
Easy appointment scheduling for e-visits. Great for telemedicine! HIPAA compliance option. Embed anywhere. Integrate with 100+ apps. No coding required.
Release And Waiver Of Liability
Release and Waiver of Liability
Healthcare PDF Templates
Trust, privacy, and security are the pillars that support every company in the healthcare industry, and they’re intricately woven into the healthcare workflow. When you’re in charge of someone else’s healthcare needs, it’s important to establish your company as a sanitary, trustworthy, and professional business. A patient’s emotional and physical well-being is of the utmost importance, so hospitals and medical practitioners go to great lengths to make sure that their patients trust them.
That’s why we offer HIPAA compliance features — to ensure patients’ privacy as it relates to their medical records. Jotform is one of the few companies in the online form building industry that helps HIPAA compliance. With our PDF Editor, anyone in the healthcare industry can create fillable PDF forms or generate PDF documents as an attachment to their autoresponders. Instead of designing a PDF from scratch, we offer a wide variety of templates you can choose from as inspiration for your next design project.
These PDF templates can be used for many different use cases. For example, let’s say you need to hand out brochures about the health services you offer. Instead of giving out paper-based flyers and pamphlets, why not use something like an electronic brochure in PDF format? You can distribute these to your potential patients right after they fill out their information through an online registration form. Or you can design a simple yet professional fillable PDF form that can be downloaded and printed as a paper-based form in case you need one for your hospital’s outpatient department.
Patient Medical Record Template
Medical History Record PDF template lets you collect the patient's data such as personal information, contact information in an emergency case, general medical history. By using this sample, the doctor ensures the patient's better care and treatment.
Doctors Note Template
Create a doctor’s note for your medical practice. Sign and send to your patients. Works on mobile, tablet, and desktop devices. Drag and drop to design.
Simple Medical History Template
Once you have collected these medical data, you can record them as a pdf by using this medical history PDF template. In addition, you don't need to be worried about the safety of data.
Vaccination Record Card
A vaccination record card is a crucial document used to document the details of vaccinations received by an individual
Medical Invoice Template
Generate PDF invoices for patients with this free, easy-to-customize Medical Invoice Template. Send to patients automatically with an autoresponder.
Prescription Template
Use this Prescription Template when prescribing medications or providing treatment regimens to the patients in order to address their health complaints. This PDF document can be opened on mobile devices by using a mobile browser and then opening the standard direct link.
Pregnancy Verification Template
Verify the pregnancies of your clinic’s patients easily. Drag and drop to customize your form. Send out copies. Works on desktop, tablet, and mobile devices.
Short Medical History
Medical History Record PDF template is mostly used in order to provide significant information about the health history, care requirements, and risk factors of the patient to doctors. It is for collecting data from the patients.
Online Therapy Consent Template
Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.
Client Progress Report
Client Progress Report for Psychotherapy PDF template provides the essential information that should contain in a clinical psychotherapy report such as the name of the patient, the type of session made with the patient, the date of the session, a comprehensive assessment, and treatment goals and objective for the patient/client.
Release of Information Template
The Release of Information Template is a document that authorizes the disclosure of official or medical records to specific individuals or organizations
Professional Medical Release Template
Create a professional medical release template. Great for medical practices and therapists. Collect signatures online. Converts to PDF. Easy to customize and share.
Insurance Waiver Template
Create an insurance waiver for employees declining insurance coverage. Works great on any device. Easy to customize and share. No coding knowledge required.
Professional Medical History Template
Medical History Record PDF template is here to help you in order to know the patient's case and previous condition. You can collect data about the patient and medical background with this Medical History Record PDF sample.
Medical Records Release Authorization
Build a medical records release authorization form in seconds. Works on any device. Android and iOS compatible. Converts to a PDF. No coding knowledge required.
Dental Health Record Template
The Dental Health Record Template is easy for patients to fill out and designed to get the doctor the most important information. Patients can fill out their information on a computer or tablet using our Dental Health Record Template.
Patient Progress Report Template
A progress report is a written document that is vital in health care settings because this is where the health care practitioner will base their next plan of treatment. A good health progress report follows the ADPIE (Assessment, Diagnosis, Planning, Intervention, Evaluation) format. Using this Patient Progress Report Template, you will be able to determine if the treatment being applied is effective or not. This Sample Patient Progress Report Template has the patient's personal information, physiological and psychological health progress. The progress report specifies the patient's mood, communication, appearance, emotional status, mental stability, interventions, and respond to treatment, and the report summary.
Summer Camp Parental Consent
Create a summer camp consent form for parents of your campers. Intuitive form building. No coding required. Drag and drop to design. iOS and Android compatible.
Dietary Requirements Template
Collect important information about food restrictions and allergies. Save submissions as PDFs. Easy to customize, download, print, and share with kitchen staff.
Superbill Template
Generate healthcare superbills fast with a free template from Jotform. Great for all medical providers and specialists. Easy to customize and sync. No coding.
Personal Medical History Template
Medical History Record PDF template allows you to collect patients' data such as personal information, family history, and habits like, and symptoms. You can pick your patients with this medical history record sample.
First Aid Incident Report Template
Incidents must be reported and recorded to be sure that correct actions and treatment are made which should trigger management awareness and an investigation. The First-Aid Incident Report template contains injured person's personal details and contact details, the details and visible symptoms of injury, the Glasgow Coma Scale which is a neurological scale that expects to give a dependable and target method for chronicle the condition of an individual's awareness and brief information of treatment. Also, it contains the profile of the first-aider and signature of the person who prepares the report.
Child Medical History Template
This child medical history PDF template makes checking patients vitals and recording that important data easy. Add your own branding, adjust fields for your specific needs and then simply print out your PDF for the patient's file.
Professional Physical Therapy Consent Template
Create a professional physical therapy consent form. Collect e-signatures on any smartphone, tablet, or desktop. Easy to customize and share.
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