Real-life forms
16 min read

41 Medical Form Templates for Healthcare

Posted on April 14, 2022

Medical Form Templatesmask
41 Medical Form Templates for Healthcare

Seeing a new healthcare provider for the first time can be stressful. Instead of being shown directly to the examination room, patients know they’ll have to answer many questions about their medical history and lifestyle when they arrive.

This can be overwhelming for someone who struggles with anxiety, a neurological disorder, or limited physical mobility. One size truly does not fit all when it comes to patient intake, and medical practices should remember that accessibility is paramount.

An electronic form, as opposed to a paper form on a clipboard, can be quickly completed on a tablet or mobile device by a family member or nurse if needed. After all, if patients don’t have an easy way to fill out all the necessary forms, their experiences with the facility can be so negative they may not return.

You can avoid this scenario by using our form builder and these forms to make your onboarding process smooth and offer patients a more pleasant medical experience:

1. Enrollee Prescription Drug Claim Form Template

enrollee prescription drug claim form

 

Who needs this?

Medical facilities can share this enrollee prescription drug claim form with their patients to optimize their internal processes.

What’s it for?

Keep track of your patients’ medical needs easier, and start digitizing your healthcare business. Everyone will save time and be happier for it – not to mention accessibility.

Key Benefits

With a mobile-responsive layout, the forms will even be accessible from mobile devices, ensuring patients have access to them whenever they need it.

2. Member Reimbursement Form Template

member reimbursement form

Who needs this?

Organizations can use this stress-free member reimbursement form template to help members claim refunds for medical expenses.

What’s it for?

When patients pay for medical services, they can ask for reimbursements using this digital form in a simple, straightforward manner.

Key Benefits

Easy access for patients, quick data collection for organizations, as well as safe and secure data collection and management.

3. Medical Authorization Form Template

medical authorization form

Who needs this?

Healthcare centers need online medical authorization forms readily available since patient authorization is key to maintaining their right to medical information privacy.

What’s it for?

Generally, medical authorization forms grant authorization from the patient to a third party, such as a healthcare center or an insurance company, to access the patient’s medical record.

Key Benefits

HIPAA-compliant forms help you never lose critical information, protect your medical practice, and save time through digital authorization.

4. Medical Indemnity Form Template

medical indemnity form

Who needs this?

If you’re consulting athletes or performers, customize this medical indemnity form template and use it to collect medical consents and indemnity.

What’s it for?

Medical indemnity aims to protect surgeons and have the insurance company pay compensation to the patient in case of an accident, malpractice, or negligence claim.

Key Benefits

Customize the form to cover any information you need, and even make it HIPAA compliant. Add to that quick data collection and not getting caught up in the paperwork any longer!

5. Psychological Assessment Form Template

psychological assessment form

Who needs this?

Medical professionals need psychological assessment forms that can be used to study and understand their patients’ medical and personal history.

What’s it for?

The psychological assessment form is an analytical tool that is used to gather relevant information about a patient’s behavior, characteristics, and personality.

Key Benefits

Use conditional logic to open questions relevant to the patient, make it easy to record essential information versus taking notes, and have quick digital access to files for any data comparison/check.

6. Hospital Discharge Form Template

hospital discharge form

Who needs this?

Medical facilities use the hospital discharge form when their patients are returning home or being transferred to another facility.

What’s it for?

Prevent healthcare data loss by using this hospital discharge form template to help your patients or their loved ones sign their discharge paperwork online.

Key Benefits

This customizable hospital discharge form template helps ensure a seamless transition and doesn’t require writing a single line of code. Not to mention a much better patient experience!

7. Medical Information Form Template

medical information form

Who needs this?

Find out more about your patients and their medical history with this form. Explore their condition and gain a clear understanding of their current state.

What’s it for?

A medical information form is a document that a patient fills out with details about their medical condition to help doctors prepare for future treatment or assistance.

Key Benefits

Quickly gather patients’ details, emergency contact, medical history, insurance information, and digital signature. Reinforce it with HIPAA compliance in just a few clicks!

8. Massage Therapy Consent Form Template

massage therapy consent form

Who needs this?

Massage therapists will greatly benefit from having a massage therapy consent form at hand to give out to their newer clients.

What’s it for?

Find out your client’s details, the areas they want you to focus on, details about their previous experience with massage therapists, and whether they were recommended to you by a physician.

Key Benefits

Easy and transparent way to inform clients of the procedure’s risks and benefits. Protect your business by obtaining their consent to undergo the procedure!

9. School Entry Health Form Template

school entry health form

Who needs this?

Schools will be able to use the school entry healthy form template to create online records of their students’ medical history.

What’s it for?

Use this form template to collect data about a student’s health history and medical conditions.

Key Benefits

Get quick access to critical information and reduce paperwork. Plus, since it can all be filled out digitally, you can save time otherwise spent on school visits.

10. Dental Claim Form Template

dental claim form

Who needs this?

Insurance companies and dental clinics will benefit from this dental claim form template that can help them improve the process of applying for insurance benefits.

What’s it for?

Share this dental claim form with your patients to report dental services to a patient’s dental benefits plan and improve your dental services.

Key Benefits

Optimize your internal processes and digitize your dental business. You can even use conditions and calculations to obtain the total amount to be claimed.

11. Patient Registration Form Template

patient registration form

Who needs this?

This patient registration form can be used by health institutions looking for a digital way to collect personal patient information online and register their patients.

What’s it for?

Create a safe, paper-free way of collecting patient information upon registration by grabbing this quick, easy-to-use, drag & drop patient registration form template.

Key Benefits

Customize it to your specific needs and embed it on your website or share it with patients online. You can even load it on a tablet and share it with patients when they arrive. Seamless patient experience, happy medical staff!

12. Dental Treatment Plan Form Template

dental treatment plan form

Who needs this?

Dental practices can use this form template for treatment planning cases that span multiple visits.

What’s it for?

Use this digital dental treatment plan form in your practice to better organize records and easily track patient dental history.

Key Benefits

Easy to share with the patient and have a common understanding of the treatment, clear communication, straightforward records of the dental treatment plan.

13. Blood Donation Form Template

blood donation form

Who needs this?

Hospitals, clinics, and blood banks can use the blood donation form template to register available blood donors.

What’s it for?

Register blood donors that want to donate blood at your clinic so that you can reach them when in need and save your patients’ lives.

Key Benefits

Make it easy for donors to express their willingness to donate blood, and save precious time by quickly accessing digital records.

14. Dental Treatment Consent Form Template

dental treatment consent form

Who needs this?

Dental Practices need to present to patients this consent form before dental treatments. Patients have the right to accept or reject dentist recommendations.

What’s it for?

The dental treatment consent form template is a written authorization signed by patients about to undergo dental procedures. Dental practices have the responsibility to get consent from patients before performing treatments.

Key Benefits

Streamline medical workflows, ensure digitization, and prevent legal action with the consent form. Make it as complex as needed, adapt it to the medical procedures, and easily customize it.

15. Health Screening Form Template

health screening form

Who needs this?

Use the health screening form template to gather health information about new patients coming to your medical facility.

What’s it for?

Health screening forms are used to securely gather patient information, screen for preexisting conditions, and even pre-screen for COVID symptoms.

Key Benefits

Easily customize this template to find out patients’ personal data and medical history. Then publish the form and have the patients complete it – digitally or in-person on a tablet or smartphone.

16. Dental Insurance Verification Form Template

dental insurance verification form

Who needs this?

The dental insurance verification form template is used in dental practices to request a patient’s insurance information from their insurer.

What’s it for?

It’s easy to use this online dental insurance verification form in your practice to check if the patient has insurance, so you know how to bill for your medical services.

Key Benefits

Quickly collect insurance information, avoid misunderstandings, and simplify billing processes.

17. Medical Examination Report Form Template

medical examination report form

Who needs this?

A medical examination report form is a document that must be completed by a person in order to qualify for or keep a current job.

What’s it for?

Conduct medical consultations for those in need with more ease with the help of a digital medical examination report form.

Key Benefits

Easily record data, generate reports (in PDF, if needed), use conditional logic to expand only relevant information, and speed up the examination process.

18. Medical Certificate Form Template

medical certificate form

Who needs this?

Individuals that intend to obtain or renew their driving license need a certificate that shows their capabilities to see, hear and drive without medical impediments.

What’s it for?

This medical certificate form template can be customized and used for collecting data about individuals that intend to obtain or renew their driving license.

Key Benefits

Simplify the process and give your patients easy access to request your services.

19. Nursing Report Form Template

nursing report form

Who needs this?

This report template is useful to nurses visiting patients who need a way to assess and record their medical status.

What’s it for?

A nursing report form helps track daily changes in patients that require continuous supervision and identify any problems and required interventions.

Key Benefits

This form can be used as a checklist, it reduces human error, records essential data, and is easy to be reviewed by doctors!

20. Psychology Referral Form Template

psychology referral form

Who needs this?

Medical professionals can now easily refer a patient to a therapist, physician, agency, or institution for evaluation, consultation, or treatment using this form.

What’s it for?

Simplify psychology referrals by using this form template, and help your patients see a psychologist easier.

Key Benefits

Improve collaboration within the medical community, ensure your patients get help from qualified professionals, and improve patient satisfaction with this form.

21. Dental Procedure Medical History Form Template

dental procedure medical history form

Who needs this?

Dental practices can easily collect the data they need before a dental patient’s first appointment with this dental procedure medical history form template.

What’s it for?

Collecting and maintaining a patient’s dental history is essential to successful treatment, so share this form with your patients to improve your medical services.

Key Benefits

This form can help doctors see patients’ health evolution, adjust treatment, avoid overlooking critical information, and ensure safe & secure data collection.

22. Immunization Waiver Form Template

immunization waiver form te

Who needs this?

Medical facilities can share this immunization waiver form template with their patients to help them avoid receiving a vaccine that might harm them.

What’s it for?

An immunization waiver can help a patient become a medical exemption if they have a medical condition that prevents them from receiving a vaccine.

Key Benefits

Share it easily with patients, avoid unnecessary appointments, and protect the patient and your clinic with this form.

23. Insurance Verification Form Template

insurance verification form

Who needs this?

Medical facilities and healthcare providers worldwide can verify a patient’s insurance coverage with this form – just make sure to include all the right questions.

What’s it for?

An insurance verification form is a document that helps clinics check the medical coverage of their patients before they receive medical services. Use our template to collect the patient’s insurance details and improve your onboarding process.

Key Benefits

With one of our HIPAA compliance plans, you can add another layer of security to the form and keep all the medical records safe.

24. Health Evaluation Form Template

health evaluation form

Who needs this?

Medical facilities can use this health evaluation form to take the pulse of their patients. Record everything in one step and easily manage all the information.

What’s it for?

Health evaluation forms are used by hospitals and other medical facilities to collect accurate data to be used for patient evaluation.

Key Benefits

Having this evaluation filled out before the appointment can win you more time with the patient, help doctors prepare for appointments, and streamline patient onboarding.

25. Psychotherapy Intake Form Template

psychotherapy intake form

Who needs this?

Psychotherapists looking to obtain information from a new client can use this form to collect answers regarding personal information, past treatment, medications, and reasons why they are seeking therapy.

What’s it for?

This form helps psychotherapists get information about the background of a client. The client or their representative needs to complete this form before the session. It serves as the therapist’s guide to create a session plan.

Key Benefits

Using this free online form template can save you a lot of time. Use the simple drag-and-drop tool to make any layout modifications. No coding skills are needed!

26. Dental Enrollment Form Template

dental enrollment form

Who needs this?

Businesses can quickly collect employee data to enroll them in a dental health care plan using this easily customizable form.

What’s it for?

A dental enrollment form is the first step towards getting dental insurance. Applicants mention the number of dependents in the form, fill it out and submit it to their employer or insurance company in order to reduce dental care costs in the future.

Key Benefits

Ditch the paperwork, streamline workflows, digitize processes, and integrate with other tools for easy data management.

27. Veterinary Release Form Template

veterinary release form

Who needs this?

A veterinary release form template can help veterinarians keep a straight record of pet owners’ authorizations regarding their pets’ medical treatments.

What’s it for?

A veterinary release form is a document that pet owners sign authorizing the veterinarian to administer the appropriate medical treatment to the pet.

Key Benefits

Quickly obtain consent to perform relevant medical procedures and ensure the pet owner is fully informed while you’re legally protected.

28. Nursing Assessment Form Template

nursing assesment form

Who needs this?

Registered nurses can use a nursing assessment form to evaluate patients’ medical condition and symptoms.

What’s it for?

Healthcare providers can use this form to simplify the way nurses evaluate the patient’s medical state, quickly check on patients, and document their condition.

Key Benefits

With the nursing assessment form, the data will be stored safely and securely while doctors better understand the patient’s medical evolution.

29. Patient Monitoring Form Template

patient monitoring form

Who needs this?

Nurses, physicians, or any healthcare provider can use this patient monitoring form template to observe patients in a systematic way.

What’s it for?

Monitoring your patients in a consistent, professional manner with this easy-to-use form template will help you and your team keep track of any changes.

Key Benefits

Customize it with just a few clicks and share it with your team for a streamlined monitoring process.

30. Proof Of Immunization Form Template

proof of immunization form

Who needs this?

Medical facilities may occasionally need to offer patients proof of their immunization. The easiest way to do it is by filling out this form.

What’s it for?

Vaccination records (sometimes called immunization records) provide a history of all the vaccines a patient has received.

Key Benefits

Help patients obtain access to their records and the proof of immunization whenever they need it. You can even generate PDFs and obtain digital signatures.

31. Medical Consultation Form Template

medical consultation form

Who needs this?

Healthcare organizations can use this medical consultation form to collect information from patients before a consultation.

What’s it for?

Use our medical consultation form template to collect information from patients before a consultation, to have an overview of the patient’s medical condition.

Key Benefits

HIPAA compliance, safely and securely collected and stored data, improved patient experience, and data accuracy are only some of this form’s benefits.

32. Nutrition Consultation Form Template

nutrition consultation form

Who needs this?

Are you a nutritionist looking for an easy way to understand your patients and their dietary habits? Then this form will definitely help you.

What’s it for?

Make your processes simple, accessible, and organized by using this nutrition counseling form template and sharing it online with your patients.

Key Benefits

This form can help nutritionists prepare for appointments, ensure patient satisfaction, better medical services, and zero waiting time. Also – zero paper forms!

33. Ambulance Transfer Form Template

ambulance transfer form

Who needs this?

Hospitals may need to organize ambulance transfers between each other.

What’s it for?

Get the 123FormBuilder’s ambulance transfer form template to digitally organize ambulance transfers from one hospital to another.

Key Benefits

This form can help with saving precious time (unlike paperwork!) and quickly collect digital signatures whenever critical transfers may happen.

34. Immunization Exemption Form Template

immunization exemption form

Who needs this?

Healthcare providers and medical facilities use this immunization exemption form template to allow patients to ask to be exempt from a vaccine.

What’s it for?

A medical facility’s patients can ask for a medical exemption if a vaccine wouldn’t be safe for them because of a disease or medicine that weakens their immune system.

Key Benefits

Keep records of your patients regarding their immunization status, and better plan your work with the help of this form.

35. Mental Health Survey Form Template

mental health survey

Who needs this?

Mental health professionals during their patient intake process would benefit from using this form.

What’s it for?

Online screening is one of the quickest and easiest ways to determine whether your patients are experiencing symptoms of a mental health condition.

Key Benefits

Simplify the onboarding process, ensure easy data collection, and integrate the form with Dropbox or Google Drive to store records.

36. Patient Encounter Form Template

patient encounter form

Who needs this?

Healthcare organizations, clinics, hospitals, and physicians who need to record their patients’ last visits, can do so with this patient encounter form template.

What’s it for?

Documenting the appointment and writing down the diagnosis and procedure codes so the clinic knows what procedure to bill and how much it costs.

Key Benefits

You can add the medical information you need, store it in a secure repository, sync it with other tools, and print the information on paper.

37. Ambulance Checklist Form Template

ambulance checklist form

Who needs this?

Ambulance staff will find this checklist useful when keeping track of what may be missing from their ambulance.

What’s it for?

This is an online ambulance checklist form that your staff may use from any device that has online access.

Key Benefits

Reduce human error, streamline work processes, and share it easily with the team – so that no matter who uses the ambulance can quickly assess how well the ambulance is equipped.

38. Appointment Request Form Template

appointment request form

Who needs this?

If you want to offer patients an easy way to make an appointment and you want to keep all your appointments organized on your end, this form is for you.

What’s it for?

Have your customers create appointments with your medical center as easily as ever with this appointment request form template.

Key Benefits

Easy appointment management, being more responsive to patient requests, integrating with email service providers such as MailChimp for personalized communication, and using conditional logic to expand fields depending on their appointment request are only some of this form’s benefits.

39. Caregiver Consent Form Template

caregiver consent form

Who needs this?

Healthcare organizations use the caregiver consent form to collect consent from parents or legal guardians prior to providing medical services.

What’s it for?

Create and personalize a caregiver consent form using our friendly online template to allow parents to authorize another person to make healthcare choices for their children in their absence.

Key Benefits

Obtain consent in just a few clicks with digital signatures, and skip useless, time-consuming paperwork.

40. Dental Assistant Evaluation Form Template

dental assistant evaluation form

Who needs this?

This pre-made form sample helps externship supervisors to quickly assess the activity of students who work as dental assistants.

What’s it for?

Assess your dental assistants’ performance with this form template and track their progress.

Key Benefits

Use this form as a checklist to quickly put down your observations in a consistent way, save time by recording your evaluation digitally, quickly share with your team or student in your 1:1 meetings, and even personalize it for each type of assignment.

41. Organ Donation Form Template

organ donation form

Who needs this?

Medical facilities can use this form to share it with their patients that may be interested in becoming organ donors.

What’s it for?

Share this organ donation form with people that are interested in donating their organs or tissues after their death.

Key Benefits

This template helps you create a database of donors, connect to your other favorite tools, such as Dropbox or Google Sheets, and receive notifications when someone registers.

FAQ

Why are medical forms important?

Good medical records, including forms filled out by patients themselves – whether electronic or handwritten – are essential to the continuity of care for your patients. Plus, accurate medical records are critical for healthcare professionals when defending against a clinical negligence complaint or lawsuit. They provide insight into the clinical judgment exercised at the time.

How important is a patient consent form?

Although HIPAA may not specifically require it, consider always using a patient consent form in your practice. A consent form specifies the methods by which a patient agrees to allow your practice to use their protected information. Should a patient ever complain that their privacy rights have been violated, a consent form can provide you with an additional level of protection if your practice is investigated for HIPAA non-compliance.

Why should I choose an electronic form over a paper one for my practice?

Patients that consider themselves “confident” filling out medical forms have little difficulty understanding medical information, but not everyone feels the same way. Unfortunately, age and health can affect one’s ability to discern information, so filling out form after form can become stressful. Similarly, depending on their level of knowledge and education, patients can feel overwhelmed by the amount of paperwork in front of them. A simple electronic form, as opposed to a paper form on a clipboard, can be quickly completed on a tablet or mobile device by a family member or nurse if needed, making all patients feel at ease.

Originally published on February 21, 2022

Don't miss a thing

Subscribe to our Newsletter to receive monthly news