Patient Registration Form Templates
New Patient Enrollment Form
New Patient Enrollment Form which personal information, contact information, emergency contact people area and medical history information are provided; allowing you to have an easier and faster registration process.
Healthcare FormsPatient Medical History Form
The template is used by patients to register medical history through providing their personal information, weight, allergies, illnesses, operations, healthy habits, unhealthy habits. You can integrate the data to your own systems.
Healthcare FormsEyelash Extension Consent Form
An eyelash extension consent form is used by professional eyelash extensionists to inform their customers of the procedure, equipment they will use, potential risks, and benefits of eyelash extensions.
Salon FormsEsthetician Client Intake Form
Use this Esthetician Client Intake Form to receive information about the client in regards to cosmetic or skin treatment. This form will surely help the technician or clinic on how they will approach the client and offer the appropriate services.
Salon FormsInitial Visit Patient Forms (MDR)
An initial visit patient form is used by medical practitioners to collect information from patients as they arrive at their practice's office for an initial visit.
Healthcare FormsCounseling Intake Form
The Counseling Intake Form allows for an easier client registration process as it automates gathering information from your clients, reduces paperwork and helps to keep patient records in a systematic way.
Healthcare Forms
Skincare Facial Consent Form
A Skincare Facial Consent Form is a form template designed to gather information from clients about their upcoming visit and their expectations of the service.
Dermal Filler Forms
Mental Health Intake Form
Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.
Healthcare Forms
Hospital Admission Form
A Hospital Admission Form is a comprehensive form template designed to streamline the patient registration process and collect essential medical information
Healthcare Forms
Medical Intake Form
A Medical Intake Form is a form template designed to collect comprehensive information about a patient's medical history, past surgeries, genetics, and symptoms
Healthcare Forms
Hospital Patient Registration Form
A Hospital Patient Registration Form is a form template designed to streamline the process of collecting patient details before their stay in the hospital.
Healthcare Forms
Life Coach Intake Form
A Life Coach Intake Form is a form template designed to streamline the coaching process for life coaches.
Consulting Forms
HIPAA Medical History Form
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.
Healthcare Forms
Patient Intake Form
Register new patients for your practice with a free online Patient Intake Form. Great for telemedicine or telehealth. Option for HIPAA friendly features.
Healthcare Forms
Nutrition Consultation Form
A nutrition consultation form is used by medical practices to record details about consultations with patients and their ongoing nutritional needs.
Healthcare Forms
Yoni Therapys Vaginal Steam Intake Form
A vaginal steam intake form is used to document the results of natural vaginal steam treatments.
Healthcare Forms
Speech/Language Pathology Progress Note
Here is a simple speech therapy progress notes template made for language therapists and healthcare provider/practitioners. This sample speech therapy progress notes will allow you to gather all the necessary information to keep the progress of your patients. By using this form template, you can also schedule appointments and make bookings for your patients.
Healthcare Forms
Body Measurement Form
A body measurement form is a physical evaluation tool used for a variety of functions from clothing design to bodybuilding.
Healthcare Forms
Dietitian Patient Questionnaire
Here is a Dietitian Patient Questionnaire that allows for new patient enrollment through collecting their personal and contact information with a detailed medical history and nutrition habits.
Medical Application Forms
Clinic Patient Registration Form
This new patient registration form, or patient intake form, gathers the necessary information that your clinic, practice, or hospital needs to onboard them into your system.
Healthcare Forms
Patient Extensive Intake Form
A patient extensive intake form is used by nursing or medical professionals to document patient information.
Healthcare Forms
Medical Insurance Verification Form Template
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
Insurance Forms
Patient Referral Form
A patient referral form is a document that is used by medical professionals in order to refer a patient to another doctor.
Healthcare Forms
New Patient Registration
A new patient registration form is used by medical practices to register new patients. Use Jotform for easy collection!
Healthcare FormsAbout Patient Registration Form Templates
Patient registration forms are documents that healthcare offices use to onboard new patients. They help gather demographic, medical, and insurance information during the intake process so that healthcare offices can easily add patients to their records. Registration forms are the first step to establishing patients’ medical records. They also set them up to receive quality care that’s tailored to their needs.
Types of patient registration forms
There are different types of patient registration forms, depending on the healthcare facility and the type of care that a patient is seeking. For example, there are general intake forms, telehealth forms, admission forms, insurance forms, treatment forms, new patient questionnaires, and more. Each facility will tailor the registration forms to its exact needs.
Key elements of patient registration forms
The key elements of patient registration forms include information about the patient, such as name, email, phone number, address, date of birth, etc. These forms may also ask for the patient’s insurance details to connect with their insurance company. The patient registration form also usually asks for emergency contact and demographic information. Finally, they can ask about any other information the practice should know about, like the patient’s personal and family medical history.
Benefits of using patient registration forms
There are many benefits to using patient registration forms! Primarily, these forms provide an easy way to collect information from new patients quickly and effectively, allowing providers to come up with a customized treatment plan. They also allow insurance companies to analyze patient eligibility to determine coverage. Online patient registration forms also greatly reduce the administrative workload in healthcare offices by enabling automation, streamlining data-sharing, and minimizing errors from manual data entry.
Use cases for patient registration forms
Patient registration forms have a plethora of use cases, such as registering new patients, updating contact information for existing patients, and gathering additional health information for specialist practices. Patients can also use these forms to register for certain medical programs, treatments, or trials, such as rehabilitation or wellness centers. Because telehealth is an increasingly common option, practices may also need specific telehealth registration forms.
How do I create patient registration forms with Jotform?
Creating a patient registration form is easy with Jotform! Just choose a template from our template library , and customize it in our drag-and-drop form builder — no coding required. You can add form fields, upload images and videos, adjust fonts and colors, and much more. When you’re finished, share it via email, link, or QR code, or by embedding it in your website.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.