Telehealth Forms

97 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.

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Coronavirus Screening Form

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

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Sample Request Form

A sample request form is a quick and easy way to ask for examples of a product or service from a business.

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Mental Health Intake Form

Perform patient intake online. Collect medical history, supporting documents, and fee payments. Protect patient data with optional HIPAA compliance.

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Teletherapy 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.

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Telehealth Consent Form

Get informed consent from patients online. Collect electronic signatures. Easy to customize for your practice.

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Telemedicine Consent Form

Get consenting e-signatures online from your patients. Add terms and conditions without coding.

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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.

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Nutrition Consultation Form

A nutrition consultation form is used by medical practices to record details about consultations with patients and their ongoing nutritional needs.

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Reiki 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.

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Physician 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.

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Virtual Care Appointment Form

Easy appointment scheduling for e-visits. Great for telemedicine! HIPAA compliance option. Embed anywhere. Integrate with 100+ apps. No coding required.

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Medical Volunteer Application

Collect medical volunteer registrations online with our free Medical Volunteer Application Form. Easy to customize and embed. Ideal for emergency response.

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Telemedicine Appointment Form

Let patients request virtual appointments online. Add a calendar field without coding. HIPAA compliance features. Perfect for telemedicine providers.

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Telehealth 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.

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Telemedicine 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.

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Sample 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.

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Telemedicine 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.

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Psychedelic Experience Intake Form

A psychedelic experience intake form is part of an online survey used to collect detailed information about a psychedelic experience.

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Telehealth 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.

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Dermatology 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.

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Pre 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.

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New 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.

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Telehealth Physical Therapy Consent Form

Offering virtual physical therapy appointments? Collect signatures and payments from patients online. Easy to customize and integrate. HIPAA compliance features.

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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.