Patient Registration Form

Medical rooms, private practices, clinics & hospitals use the new patient forms to register patients into their medical facility’s system so they can provide proper care. Patients can fill it out on their digital device and have it ready before their first appointment. It helps healthcare workers complete the patient registration process ahead of time and speed up the entire intake process.

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What is a Patient Information Form?

The patient information form is a document that helps healthcare staff to collect personal and health information from new patients and register them. Whether it’s primary care or acute care, you want to shorten the waiting time in the medical room and provide safe and effective medical assistance. With 123FormBuilder’s patient information form, you can collect the patient’s data online and have their medical records ready upon arrival at your facility. While these forms are widely used in healthcare settings, they can also serve well to organizations that potentially handle medical data, such as schools or sports leagues.

What Information is Needed for a New Patient?

When registering new patients in your system, these are some of the information you need to collect:

Contact details
Demographic information
Basic health information (medical condition, medications, health history, family health history, etc.)
Insurance information (insurance card, billing info, etc.)
Past medical records (diagnostic reports, medical releases, etc.)

HIPAA Compliant Patient Form

To make a new patient form HIPAA compliant, you only need a 123FormBuilder account. 123FormBuilder is 100% HIPAA compliant, which means that with an Enterprise plan, you can activate the HIPAA option and enjoy the advanced security measures that protect the ePHI you collect with our HIPAA compliant forms.

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Benefits of Using a Secure 123FormBuilder Template

If you need a quick and easy way to register new patients, 123FormBuilder patient forms can help you collect data safely and securely without wasting precious time.

Customize template

Start from scratch or grab a template from the 123FormBuilder patient forms gallery and start customizing it using our drag&drop editor. Style it according to your brand, rearrange fields, add your logo, and even a signature field (in case you’re building consent forms). And when you’re done, just hit enter, and that’s it. You don’t need any coding skills, so you can have it ready to use in just a few minutes. Make it easy for patients to complete it and for you to assess the data.

Collect & Manage Data Safely

Once it’s ready, share the form on your website, include it in your online patient packet, send it via e-mail and start collecting data. Rely on 123FormBuilder’s strong security measures and HIPAA compliance to protect the privacy and integrity of ePHI.

Optimize processes

Any completed form that a healthcare provider gets before the appointment is a step forward to a smoother healthcare experience and more time for doctors to focus on providing care. Using 123FormBuilder’s patient forms allows you to collect data accurately, reduce the risk of human error, provide easy access to medical records (you don’t have to search through piles of paper forms), and improve the overall intake process.

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Medical Information Form FAQs

What kind of questions will be asked in a patient intake form?

Intake forms usually collect information about the patient: contact details, health history, insurance, billing information, demographic data, and emergency contact.

What is a patient information sheet?

The patient information sheet is a document used by healthcare providers (doctors, medical facilities, etc.) to guarantee compliance with the patient’s right to have their medical data privacy protected and used only for medical purposes.

What does it mean to register a patient in a hospital?

Whether the patient has an appointment or requires emergency care, the hospital will open a file and register them in their system by collecting and recording their personal and health data.