Medical Application Forms

An online doctor appointment form is used by medical practices to schedule medical appointments through the practice website.

Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA friendly features.

This blood donation form lets you provide a health clinic, hospital, or blood bank with the information they need to add you to their subscriber link for blood donors. Fully customizable and free.

Collect informed patient consent and e-signatures online with a free Teletherapy Consent Form. Great for remote medical services. Get HIPAA compliance today.

Use this detailed intake form for your healthcare/rehabilitation facility, capture patient information with an agreement between you and the patient.

A Medical Intake Form is a form template designed to collect comprehensive information about a patient's medical history, past surgeries, genetics, and symptoms

HIPAA Medical History Form allows gathering patient's contact details with their current symptoms, medications, allergies, drug use, and family medical history that allows for a better healthcare service and management process.

Efficiently write your Doctor Referral form by directly providing the information in the form. Send your referrals instantly using this Doctor Referral Form.

Register new patients for your practice with a free online Patient Intake Form. Great for telemedicine or telehealth. Option for HIPAA friendly features.

The COVID-19 Client Health Questionnaire is a document that physicians and vaccine experts use to collect information from their clients. Just customize this template without coding!

Collect client contact info and e-signatures online with a free Reiki Intake Form. Easy to customize, embed, and fill out on any device. Sync with 100+ apps.

A patient extensive intake form is used by nursing or medical professionals to document patient information.

A Medical Insurance Verification Form Template is a form template designed to streamline the process of verifying coverage details and insurance eligibility for healthcare providers, hospitals, and medical clinics

Check the needs of the patient by using this Chiropractic Intake Form. This will serve as a health record of the patient where the chiropractors can base on how they will proceed with the treatment.

A waxing consultation form is a form used by estheticians for collecting information regarding the needs of a customer that plans to get a wax treatment. Use this Waxing Consultation Form without coding!

A prior authorization form is a form used by medical professionals to confirm that a patient has pre-existing coverage for specific medications and medical procedures. Collect info with this free form!

A Medical Staff Application Form is a form template designed to streamline the process of hiring medical staff and collecting essential information about new medical staff

Prescribe medication refill online by using this Prescription Refill Form Template. This form template can be easily accessed in any device like smart phones, tablets, and laptops.

A medical consultation form is a medical questionnaire used by medical professionals to consult patients about their health and past experience with related diseases. Use this no coding template from Jotform!

Enjoy a seamless intake process for new patients at your practice. Great for telemedicine. Collect medical history, e-signatures, and more.

Use this free Patient Waiting List template to sign up potential patients for their examinations and treatment.

Here's a pediatric intake form to evaluate children's health needs. If you are a pediatrician, you can use this pediatric history template to connect with the children's parents or guardians quickly and easily, get valid answers about their child's health and a lot more information. Use this pediatric health history form template to provide comprehensive health care and a complete understanding of the patient’s physical, mental and emotional condition and history.

The Against Medical Advice Form is a document signed by patients, which authorizes doctors to release their patients against the advice of physicians.

Monitor office visits with this free Patient Encounter Form. Easy to customize and fill out from any device. HIPAA compliance features. No coding required.