COVID-19 Pre-Visit Screening Questionnaire
About this free form template

Healthcare providers need a fast, reliable way to screen patients before appointments—and a COVID-19 Pre-Visit Screening Questionnaire built with Paperform gives you exactly that. This template helps medical offices, clinics, dental practices, and allied health facilities collect critical health information before patients arrive, reducing waiting room risk and streamlining your check-in process.

Whether you're a small GP practice, a busy dental clinic, or a multi-location healthcare network, this pre-visit screening form captures symptoms, exposure history, vaccination status, and contact tracing consent in one clean, mobile-friendly workflow. Patients can complete it from home on any device, and your front desk gets instant visibility into who's safe to see and who needs additional protocols.

Why Paperform works for healthcare screening:

Paperform's conditional logic ensures patients only see relevant follow-up questions based on their answers—keeping forms short and reducing abandonment. Built-in calculations and routing let you automatically flag high-risk responses, send different confirmation messages, or trigger alerts to your team via email or Stepper workflows.

You can embed this form directly into appointment confirmation emails, link it from your booking software, or place it on your website—no developer required. And because Paperform is SOC 2 Type II compliant, you can trust that patient data is handled securely (note: Paperform is not HIPAA compliant, so use in conjunction with your existing compliant systems).

For practices managing multiple locations or departments, Paperform's Agency+ plan lets you create branded versions of this screening form for each site, with centralised reporting and role-based access for your admin team.

Take the guesswork out of COVID-19 screening and keep your patients, staff, and waiting rooms safe with a professional pre-visit questionnaire that works as hard as you do.

Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Built for growing businesses, trusted by bigger ones.
Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. Small and growing teams across marketing, eCommerce, education, and professional services run their forms on Paperform.

Our customers love us, with an average rating of 4.8 out of 5 from 380 reviews across Capterra, Trustpilot, and G2.