Patient Confidentiality Agreement
Give your patients peace of mind that their sensitive medical data is safe with this Patient Confidentiality Agreement. Simply customize this template however you see fit, then share your form via email. Patients can then fill out this agreement form from any smartphone, tablet, or desktop computer. You’ll receive an email notification and a signed and finalized version of the document in your online dashboard.
Make changes to this Patient Confidentiality Agreement with our drag-and-drop builder. Change the agreement terms, add new text boxes or signature fields, upload your clinic’s logo, choose fonts and colors, and much more without any coding knowledge. Once a patient fills out and signs your document, you can instantly print and download it as a PDF document for your records. Say goodbye to messy paperwork and keep everything safe and secure with Jotform Sign.
Hospital Discharge Template
The Hospital Discharge Template is a detailed document that provides patients with instructions and information upon discharge from a healthcare facility
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 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.
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.
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.
NonProfit Donation Consent Template
Create a nonprofit donation consent form in seconds. Drag-and-drop to design and customize. Collect signatures from any smartphone, tablet, or desktop.
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.