Patient Intake Form Template

Intake forms are the perfect opportunity to collect important information from new patients. Whether you run a private practice or medical centre, you could save a lot of time by collecting patient information prior to their first appointment. Using a patient intake form can also help medical professionals acquaint themselves with the history of new patients to provide a more efficient and tailored service.

You can email this intake form to new patients or embed this form to your website to easily collect information and store it using spreadsheets or PDFs. Save time and manage patient records through this form and 1000+ integrations.

Customise this intake template, add the logo for your practice and tailor questions and typography as needed. Simply click on "Use this template" below to get started.