Geriatric Medicine Comprehensive Assessment Form

Streamline Geriatric Patient Assessments with Paperform

Caring for older adults requires a holistic approach that goes beyond traditional medical intake. This Geriatric Medicine Comprehensive Assessment Form template is designed specifically for geriatricians, senior care clinics, and healthcare providers who specialize in the unique needs of aging patients.

Built with Paperform's flexible form builder, this template captures essential information across multiple domains: medical history, fall risk factors, cognitive function, medication management, functional independence, nutritional status, social support, and advance care planning. The structured format ensures you don't miss critical details while maintaining a patient-friendly experience that accommodates the needs of older adults and their caregivers.

What makes this template ideal for geriatric practices

The form uses conditional logic to adapt questions based on responses—for example, if a patient reports a recent fall, additional fall risk questions appear automatically. This creates a personalized assessment while keeping the form streamlined for those who don't need every section.

Medication reconciliation is built directly into the form, allowing patients or caregivers to list all current medications, dosages, and frequencies in one organized section. You'll also capture information about cognitive concerns, daily living activities (ADLs and IADLs), mobility aids, and social determinants of health that significantly impact geriatric care.

The advance directives section provides a sensitive, clear way to discuss healthcare preferences, proxy designation, and end-of-life wishes—conversations that are essential in geriatric medicine but often get postponed.

Automate your geriatric workflow with Stepper

Once a patient submits their assessment, use Stepper to automatically route the information where it needs to go. You can create workflows that add the patient to your EMR system, flag high-risk patients for immediate clinical review, schedule follow-up appointments, send welcome packets, or notify care team members about specific concerns identified in the assessment.

For practices that need signed consent forms or advance directive documentation, Papersign can automatically generate and send legally binding eSignature documents based on the intake responses, creating a seamless onboarding experience while maintaining complete compliance.

Built for the pace of modern geriatric care

Whether you're a solo geriatrician, part of a multi-specialty clinic, or running a dedicated senior health center, this template helps you gather comprehensive patient information before the first appointment. Patients or their caregivers can complete the form at home, giving your clinical team time to review complex medical histories and prepare for more meaningful, efficient visits.

Paperform is SOC 2 Type II compliant and offers data residency controls, making it a trustworthy solution for healthcare practices that need to protect sensitive patient information while delivering exceptional care to older adults.