Telehealth Forms
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.
Go to Category:Healthcare FormsCoronavirus Screening Form
Prevent the spread of COVID-19 with a free Coronavirus Screening Form. Ideal for doctors’ offices and telemedicine. HIPAA friendly features.
Go to Category:Healthcare FormsSample Request Form
A sample request form is a quick and easy way to ask for examples of a product or service from a business.
Go to Category:E-commerce FormsMental Health Intake Form
Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.
Go to Category:Healthcare FormsTeletherapy Consent Form
Collect informed patient consent and e-signatures online with a free Teletherapy Consent Form. Great for remote medical services. Get HIPAA compliance today.
Go to Category:Healthcare FormsTelehealth Consent Form
Get informed consent from patients online. Collect electronic signatures. Easy to customize for your practice.
Go to Category:Healthcare FormsTelemedicine Consent Form
Get consenting e-signatures online from your patients. Add terms and conditions without coding.
Go to Category:Healthcare FormsHIPAA 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.
Go to Category:Healthcare FormsNutrition Consultation Form
A nutrition consultation form is used by medical practices to record details about consultations with patients and their ongoing nutritional needs.
Go to Category:Healthcare FormsReiki Intake Form
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.
Go to Category:Telehealth FormsPhysician Referral Form
Refer patients to other physicians and collect referrals online. Easy to customize and embed. Integrate with 100+ apps. HIPAA friendly features option. No coding.
Go to Category:Healthcare FormsVirtual Care Appointment Form
Easy appointment scheduling for e-visits. Great for telemedicine! HIPAA compliance option. Embed anywhere. Integrate with 100+ apps. No coding required.
Go to Category:Healthcare FormsMedical Volunteer Application
Collect medical volunteer registrations online with our free Medical Volunteer Application Form. Easy to customize and embed. Ideal for emergency response.
Go to Category:Healthcare FormsTelemedicine Appointment Form
Let patients request virtual appointments online. Add a calendar field without coding. HIPAA compliance features. Perfect for telemedicine providers.
Go to Category:Healthcare FormsTelehealth Counseling Consent Form
Collect consent forms and e-signatures with an online Telehealth Counseling Consent Form. Easy to customize and share. Opt for HIPAA friendly plans.
Go to Category:Healthcare FormsTelemedicine E Visit Request Form
Accept requests for e-visits through this free online appointment form. Easy to customize. embed, and share. Integrate with 100+ apps. HIPAA compliance features.
Go to Category:Telehealth FormsSample Telemedicine Consent Form
Collect informed consent and e-signatures from patients with a free Sample Telemedicine Consent form. Easy to customize, embed, and share. HIPAA friendly features option.
Go to Category:Medical Consent FormsTelemedicine Patient Evaluation Form
Evaluate your patients remotely with an online Telemedicine Patient Evaluation Form. Easy to share and collect data on any device. Opt for HIPAA compliance features.
Go to Category:Telehealth FormsPsychedelic Experience Intake Form
A psychedelic experience intake form is part of an online survey used to collect detailed information about a psychedelic experience.
Go to Category:Healthcare FormsTelehealth Clinical Assessment Form
Assess the medical condition and health status of the patient online by using this Telehealth Clinical Assessment Form. This form template is simple, clean, and easy to use.
Go to Category:Healthcare FormsDermatology Telehealth Medical Examination Form
Treat patients remotely. Safely collect medical info online. HIPAA friendly features option. Accept photos of skin conditions. 30+ free payment app integrations.
Go to Category:Healthcare FormsPre Screening Form
A Pre-Screening Form is a form template designed to streamline the initial assessment process for businesses. This customizable Jotform tool helps filter candidates, collect preliminary information, and save valuable time.
Go to Category:Healthcare FormsNew Patient Appointment Form
Schedule appointments online for new patients. Easy to customize and embed. Sync to Google Calendar, Zoom, and 100+ apps. HIPAA friendly features option. No coding.
Go to Category:Healthcare FormsTelehealth Physical Therapy Consent Form
Offering virtual physical therapy appointments? Collect signatures and payments from patients online. Easy to customize and integrate. HIPAA compliance features.
Go to Category:Healthcare FormsThese 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.