Preventive Health Risk Assessment Form

Comprehensive Preventive Health Risk Assessment Form

This preventive health risk assessment form helps healthcare providers identify potential health risks before they become serious concerns. By gathering detailed information about family medical history, lifestyle factors, and screening eligibility, medical practices can deliver more proactive, personalized preventive care.

Why use this template?

For medical practices, clinics, and healthcare providers, preventive care is the foundation of better patient outcomes. This form streamlines the pre-visit assessment process by collecting comprehensive health information in advance, allowing providers to:

• Identify patients who may benefit from specific screening tests
• Understand genetic and familial risk factors
• Assess lifestyle-related health risks
• Prepare targeted preventive care recommendations
• Save valuable appointment time by gathering information beforehand

Built for healthcare workflows

This template is designed specifically for physicians, nurse practitioners, preventive care coordinators, and healthcare administrators who want to improve patient screening and early detection. The conditional logic adapts to each patient's responses, making the form feel personal rather than overwhelming.

Once submitted, you can use Stepper (stepper.io) to automatically route high-risk assessments to care coordinators, schedule follow-up screenings, update electronic health records, or trigger reminder workflows for overdue preventive tests. With Paperform's HIPAA-ready infrastructure and integrations, you can seamlessly connect this assessment into your existing practice management system.

Trusted by healthcare providers

Paperform is SOC 2 Type II compliant and trusted by over 500,000 teams worldwide. While this form collects sensitive health information securely, please note that Paperform is not a HIPAA-compliant solution by default—work with your compliance team to ensure proper use within your healthcare environment.

Whether you're a primary care practice, a preventive health clinic, or a corporate wellness program, this template helps you deliver proactive, personalized healthcare that keeps patients healthier longer.