Primary Care COVID-19 Pre-Visit Screening Form

Streamline Patient Safety with a COVID-19 Pre-Visit Screening Form

In today's healthcare environment, primary care practices need efficient ways to screen patients before appointments to ensure the safety of staff, patients, and the broader community. This COVID-19 Pre-Visit Screening Form template provides a comprehensive, professional solution for gathering critical health information before patients arrive at your clinic.

Why Primary Care Practices Need Digital Screening Forms

Paper-based screening questionnaires at check-in create bottlenecks, increase contact points, and delay care. With Paperform's digital screening solution, you can send this form to patients via email or text 24 hours before their appointment, allowing them to complete it from home on any device. This means:

• Faster check-in: Patients arrive pre-screened with results already reviewed by staff
• Reduced waiting room exposure: Identify potential COVID-19 cases before they enter your facility
• Better resource allocation: Prepare appropriate PPE and isolation rooms when needed
• Complete audit trail: Digital records with timestamps for compliance and contact tracing

What Makes This Template Work for Healthcare Providers

This template captures all essential COVID-19 screening criteria recommended by health authorities:

• Current symptoms including fever, cough, shortness of breath, and loss of taste or smell
• Exposure history to confirmed or suspected COVID-19 cases
• Recent travel history
• Current temperature reading
• Contact information for follow-up

The form uses conditional logic to tailor questions based on patient responses, making the experience efficient while capturing detailed information when necessary. If a patient indicates concerning symptoms or exposure, the form automatically flags their submission for immediate review.

How Paperform Enhances Healthcare Workflows

For healthcare administrators, medical office managers, and practice coordinators, Paperform offers features specifically valuable for patient screening:

Automated notifications: Set up instant alerts to clinical staff when a high-risk screening is submitted, so you can contact the patient before they leave home.

Integration with your EHR: Use Stepper to automatically send screening results to your electronic health record system, creating a seamless digital workflow that eliminates double data entry.

Custom success messages: Show patients clear next steps based on their answers—whether that's "You're cleared for your appointment" or "Please call us before coming in."

Brand consistency: Customize the form with your practice's logo, colors, and fonts so it feels like a natural extension of your patient communications.

HIPAA-Compliant Alternative Considerations

While this template demonstrates the power of digital screening forms, it's important to note that Paperform is not a HIPAA-compliant solution. For practices requiring full HIPAA compliance, we recommend:

• Using this template as a reference for designing forms within HIPAA-compliant platforms
• Implementing additional security measures and Business Associate Agreements with your form provider
• Consulting with your compliance officer about appropriate use cases

That said, many practices use screening forms like this for initial triage before collecting protected health information, as basic symptom questions may not always trigger HIPAA requirements depending on your specific use case and jurisdiction.

Built for the Real Needs of Primary Care Practices

This template has been designed with input from healthcare workflows commonly used by:

• Primary care physicians managing high patient volumes safely
• Urgent care clinics needing rapid triage before patient arrival
• Specialty practices screening patients for elective procedures
• Dental offices assessing infection risk before treatment
• Physical therapy clinics ensuring safe in-person sessions

The form strikes the right balance between thoroughness and brevity—comprehensive enough to catch concerning cases while quick enough that patients will actually complete it (typically 2-3 minutes).

Extend Your Screening Workflow with Automation

Once you've collected screening data, Stepper can help you automate what happens next:

• Automatic clearance notifications: Send a "You're cleared for your visit" email to patients who pass screening
• Staff alerts: Notify your front desk and clinical team when a patient needs special protocols
• Rescheduling workflows: Trigger appointment rescheduling for patients who fail screening
• Daily screening reports: Compile daily summaries of all screening results for practice management review

This level of automation transforms screening from an administrative burden into a seamless part of your patient experience, freeing up staff to focus on care rather than paperwork.

Get Started with Digital Pre-Visit Screening

Whether you're implementing COVID-19 protocols, preparing for flu season, or establishing general health screening procedures, this template provides a professional foundation. You can customize questions to match your specific clinical protocols, add your practice's branding, and deploy it to patients within minutes—no coding or technical expertise required.

With over 500,000 teams trusting Paperform worldwide and SOC 2 Type II compliance, you're choosing a platform built for professional healthcare operations. Start with this template and adapt it to your practice's unique needs, creating a safer, more efficient patient experience from the first point of contact.