Medical Scribing Service Patient Consent Form
About this free form template

Medical Scribing Service Patient Consent Form Template

As healthcare practices increasingly adopt medical scribes to improve efficiency and provider-patient interaction, obtaining proper patient consent is essential. This Medical Scribing Service Patient Consent Form template helps healthcare providers—from family practices and urgent care clinics to specialty offices—introduce scribes to patients, explain their documentation role, affirm HIPAA compliance, and secure acknowledgment for real-time charting.

Why Medical Scribe Consent Matters

Medical scribes play a crucial support role by documenting patient encounters in real time, allowing physicians to focus on patient care rather than data entry. However, introducing a third party into the exam room requires transparent communication and proper consent. This form ensures patients understand:

  • Who the scribe is and their professional role
  • What the scribe will document during the visit
  • How patient privacy is protected under HIPAA
  • The benefits of having a scribe present, including more accurate and timely medical records

Built for Healthcare Workflows

Paperform makes it easy to create professional, HIPAA-aware consent forms that integrate seamlessly into your patient intake process. While Paperform itself is not HIPAA compliant, this template is designed to capture consent in a clear, organized manner that supports your compliance workflows when paired with appropriate systems.

This template includes:

  • Scribe introduction section explaining the scribe's credentials and role
  • Documentation acknowledgment detailing what will be recorded
  • HIPAA compliance statement reassuring patients about privacy protections
  • Real-time charting consent allowing scribes to document during the encounter
  • Patient signature capture for legal consent documentation
  • Optional patient questions or concerns field for two-way communication

Automate Beyond the Form

Once a patient submits their consent, you can use Stepper (stepper.io) to automate next steps—send confirmation emails, update your EHR system, notify the scribe team, or trigger onboarding workflows. With Paperform's calculation engine and conditional logic, you can tailor consent language based on visit type, specialty, or patient preferences.

Healthcare administrators, practice managers, clinic coordinators, and physicians can deploy this form as part of new patient registration, pre-visit paperwork, or telemedicine onboarding. The doc-style editor lets you add your practice logo, customize consent language to match state regulations, and embed the form directly into your patient portal or website.

Trusted by Healthcare Teams

With SOC 2 Type II compliance, eSignature support via Papersign (papersign.com), and integrations with tools like Google Sheets, Airtable, and Zapier, Paperform gives healthcare teams the flexibility to manage consent documentation professionally and securely—without requiring developers or IT support.

Get patients onboarded faster, ensure transparency around medical scribing services, and maintain clear consent records with this ready-to-use template.

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.