Telehealth Pre-Visit Screening Form

Streamline Your Virtual Healthcare Visits with a Professional Telehealth Screening Form

The shift to virtual healthcare has transformed how medical practices connect with patients, making quality care more accessible than ever. However, ensuring a smooth telehealth experience requires proper preparation on both sides of the screen. A well-designed telehealth pre-visit screening form helps healthcare providers gather essential information before virtual appointments, ensuring both clinical readiness and technical preparedness.

Why Telehealth Pre-Visit Screening Matters

Before any virtual healthcare visit, providers need to understand the patient's current health status, verify they can access the telehealth platform, and obtain proper consent for virtual care. This pre-visit screening process helps identify potential technical issues before the appointment, ensures patients meet the clinical criteria for telehealth services, and documents COVID-19 symptoms or exposure risks that might affect care delivery.

For healthcare practices, telehealth clinics, mental health providers, and primary care physicians, having a standardized pre-visit screening process reduces no-shows, improves appointment efficiency, and creates a better patient experience from the first digital interaction.

What Makes This Telehealth Screening Form Essential

This template covers all the critical components of a thorough telehealth pre-visit assessment:

Patient Information & Appointment Details — Capture basic demographics, contact information, and appointment specifics so your team can properly route and prepare for the virtual visit.

Health Status & Symptom Assessment — Document the patient's current symptoms, reason for visit, and any changes in their condition. This helps providers prepare clinically and determine if telehealth is the appropriate care setting.

COVID-19 Screening Checklist — Include standard COVID-19 symptom checks and exposure questions that help practices maintain safety protocols and decide whether in-person care might be more appropriate.

Technology Requirements Assessment — Verify that patients have the necessary equipment (camera, microphone, internet connection) and technical capability to participate in a video visit. This proactive check dramatically reduces technical difficulties during appointments.

Telehealth Consent & Acknowledgment — Obtain informed consent for virtual care delivery, explaining the benefits, limitations, privacy protections, and patient responsibilities for telehealth services.

Perfect for Healthcare Providers Embracing Virtual Care

This form template is ideal for:

• Primary care physicians conducting routine follow-ups and minor acute care visits virtually
• Telehealth clinics and virtual-first practices managing high volumes of remote appointments
• Mental health professionals providing therapy and counseling through secure video platforms
• Specialist practices offering virtual consultations before determining if in-person care is needed
• Urgent care centers triaging patients and providing convenient virtual visits for appropriate conditions
• Healthcare systems standardizing their telehealth intake process across multiple departments

Built for Healthcare Workflows with Paperform

Healthcare providers choose Paperform because it makes creating HIPAA-conscious forms simple, without requiring technical expertise. This telehealth screening template uses conditional logic to show relevant follow-up questions based on symptom responses, ensuring you gather the right information without overwhelming patients with unnecessary questions.

The clean, professional design works seamlessly on any device—patients can complete the screening form on their phone, tablet, or computer just before their appointment. Responses flow directly into your practice management system, EHR, or notification workflow, so clinical staff can review screening information before the provider enters the virtual exam room.

Automate Your Pre-Visit Workflow with Stepper

Take your telehealth screening beyond simple data collection by connecting this form to Stepper, Paperform's AI-native workflow automation platform. When a patient submits their screening form, Stepper can automatically:

• Send different preparation instructions based on the type of appointment or symptoms reported
• Flag high-risk COVID-19 screenings for immediate staff review
• Create or update patient records in your EHR or practice management system
• Send automated reminders with video link and technical setup instructions
• Route patients who fail technology checks to a phone appointment instead
• Alert clinical staff when urgent symptoms require immediate attention

These automated workflows reduce administrative burden on your front office staff and ensure no patient falls through the cracks before their virtual appointment.

Enhance Patient Experience & Clinical Efficiency

Telehealth has proven to be more than a temporary solution—it's a permanent fixture in modern healthcare delivery. By implementing a thorough pre-visit screening process, healthcare practices can deliver higher-quality virtual care while reducing the frustration of technical difficulties and missing clinical information.

Patients appreciate knowing exactly what to expect before their appointment, and providers value having symptom information, consent documentation, and technology verification completed before they begin the clinical encounter. This preparation time allows virtual visits to focus entirely on patient care rather than administrative tasks.

Whether you're running a busy primary care practice, launching a new telehealth service line, or simply looking to improve your existing virtual visit process, this pre-visit screening form provides the professional foundation your practice needs.

Get Started with Your Telehealth Screening Form

Paperform makes it easy for healthcare practices to create, customize, and deploy professional intake forms that match your brand and clinical workflows. With over 500,000 teams worldwide trusting Paperform for their critical business processes—including healthcare providers who value our SOC 2 Type II compliance and robust security measures—you can confidently digitize your telehealth screening process.

Start with this template, customize the questions to match your specialty and state requirements, and begin offering a more organized, efficient telehealth experience today.