Patient Information Form

Patient Information Form Template

You might use this form template to collect patient information in your hospital. To make this form yours and start editing it, click the button Use this template below the description.

Collecting patient information through an online form has quite a few advantages over traditional paper forms. Filling out online forms takes less time, the information never gets lost, and the records can be easier analyzed, merged, or synchronized.

Your patients' information is safe with Paperform. Form submissions are secured using TLS 1.2 SSL from the browser through to the database. You might also disable storage submissions on Paperform, and instead, use webhooks or Zapier to push the information directly to your own database.

Should you have any questions, don't hesitate to contact our support team through the chat bubble in the bottom right corner.

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.