Prescription Form Template

This prescription form can be used by physicians and medical practices to provide patients with an easy, accessible, and secure prescription when they need it. Streamline your prescription creation processes, store them securely, and say goodbye to paper with an easy, drag-and-drop prescription form template you can find right here, on this page. Grab it, personalize it using our form builder, and then share it with your patients and drug stores via email or WhatsApp! No coding needed!

123FormBuilder / Form Templates / Medical Forms / Prescription Form

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Frequently Asked Questions

What should I include in a prescription form?

When creating a prescription form or customizing our template, make sure you include the patient’s name, date of birth, and any other information that might serve as an identifier. Next, add the medication, its strength, the amount that the patient should take, how it should be taken, how frequently, how much of it should the pharmacy give, and the number of refills. On 123 Form Builder, you can add a form field for each of these items, so you’ll be able to fill in a prescription without leaving any important details out. And once the form is completed, you can print the prescription and give it to your patient or send the prescription to the pharmacy by email.

Is this prescription form template HIPAA-compliant?

If you want to build HIPAA-compliant prescription forms, contact us and we’ll activate our HIPAA suite on your forms. Learn more about our HIPAA-complaint forms and how clinics in the US use 123 Form Builder to collect and manage PHI.

What is a medical prescription form?

A medical prescription form is a form used by health institutions to provide patients and drug stores with an easy, seamless, paper-free way of enabling patients to get prescription medicine.

What do you include in a prescription form?

A prescription form should always include patient information (including their contact details), information about the prescription options, as well as how the prescription will be delivered.

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