Medical History Form Template

Collect medical information faster with an online form your patients can complete on any device.

Simplify your workflows

The dangers of long wait times are no joke. Patients frequently abandon appointments when they tire of waiting, and often go as far as switching to a different practice. But thankfully, one of the biggest bottlenecks—disorganized data collection—is easy enough to overcome. Use this medical history template to gather patient medical information fast and keep appointments flowing. Collect everything from past prescriptions to symptoms within a matter of minutes—without the need for scanning, saving, or manual data entry.

Fill forms faster

Get everything you need, all in one form that can be completed quickly, digitally, and on any device. This medical history form is designed to let users fill out fields fast by tapping, touching, or typing. You can speed up the process even more with Social Autofill, and use Save & Resume for those times when patients can’t complete the full form in a single sitting. You’ll capture the same details collected in time-consuming paper formats, in a fraction of the time.

Collect data securely

This form template isn’t just easy to use. It’s built with HIPPA compliance in mind, too. Safely capture, store, and distribute sensitive patient data using security features designed for healthcare providers. Advanced data encryption, secure file storage, and audit logging are all included. Better yet, you can use this template along with Formstack’s equally secure new patient registration and medical release forms to further streamline data collection. Turn form data into patient documents and even have patients eSign documents where a signature is required.

Enhance the experience

Unlike traditional pen-and-paper processes, this template is designed to capture critical medical information while creating better experiences for everyone. Your patients won't be bogged down by cumbersome clipboards, and staff won’t have to decipher scribbles and scrawlings—or spend time scanning, saving, and manually entering data line by painstaking line. And with Formstack’s HIPAA compliant integrations, you can easily export medical histories to other apps as needed.

Keep it simple

Want to speed up intake even more? With Conditional Logic, you can make sure your patients see only the past medical history form template fields that are relevant to them. Show or hide questions based on previous responses and minimize the time it takes to submit important details. Additional features like Field Bottlenecks and Partial Submissions let you see which questions are causing patients to pause—and then make a few tweaks so it’s even easier for them to fill out your form.

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