Medical History Form

Medical History Form Template

Easily and securely collect medical history information from your patients with this beautiful form template. Click the button "Use this template" below to import the template into your Paperform account and start customizing it.

Medical history forms are crucial for the work of every healthcare organization. Traditionally, these forms have been provided in the paper form — which often leads to the information being lost or recorded inaccurately. Collecting the medical history information from your patients through an online form, on the other hand, has many advantages.

First of all, it's more convenient for your patients. They can fill out the form at their own pace before visiting the hospital. Secondly, it's safer and guarantees that the information won't ever be lost. You can integrate Paperform with your internal database to match and synchronize all the records with patients' profiles.

Finally, online medical history forms are more fun to fill out and feel more personal. You can use conditional logic to make certain questions or question groups appear/disappear based on your responders' answers — a huge time-saver, especially when working through a longer form.

In the After Submission settings of your form editor, you can set up automated emails to be sent out after the form is submitted. For example, you might send your responders a PDF copy of their medical history, or provide them with more information about their upcoming medical visit.

Key Features

This template is designed to help you collect information efficiently and professionally. It includes carefully crafted questions and fields that gather all the essential details you need.

Why Use This Template

• Save time: Start with a pre-built structure instead of creating from scratch
• Professional design: Looks polished and trustworthy to respondents
• Easy customization: Modify fields, colors, and branding to match your needs
• Mobile-friendly: Works seamlessly on all devices

How to Use This Template

1. Click "Use this template" to import it into your Paperform account
2. Customize the questions and fields to match your specific requirements
3. Adjust the design and branding to reflect your organization
4. Share the form link or embed it on your website
5. Start collecting responses and managing submissions

Customization Options

Paperform's visual editor makes it easy to:

• Add or remove questions
• Change colors, fonts, and images
• Set up conditional logic to show/hide fields
• Configure email notifications and integrations
• Accept payments if needed

Get started today and create a professional form in minutes.