Patient Intake Form

A patient intake form is a type of inquiry form that is filled out by a new patient when they first arrive at a healthcare facility. It is mostly created by health care providers to get information such as the patient's name, contact information, insurance information, and other relevant details. The form helps clinics to ensure that the patient's records and medical information are accurate and up-to-date.

Patient intake forms are an important part of the patient's medical record. And a patient intake form can be paper or digital, and they vary in detail depending on the facility. But creating a medical intake form online will bring you many advantages, such as being able to access them all the time or allowing patients to fill them out before coming to the clinic.

A patient intake form is an essential document to get personal information from a patient and learn about their medical history. However, it can be time-consuming to give out, collect, and store paper forms. They will be hard to find when we look for them, as well. The solution is online patient forms. Using online forms will help you save time and collect all the information automatically. Additionally, this patient intake form template comes with all the standard questions and will make the process faster.

When creating a patient intake form or a patient registration form, it is vital to ask for all the relevant information. On forms.app, you can find numerous form fields to ask and collect the information you need. It is also possible to collect files, images, or other documents with an upload field. To help you get an idea, here are some of the details you may ask from your patients:

• Personal information
• Address 
• Phone number 
• Insurance company 
• Name of primary care physician (PCP) 
• Reason for visit 
• History of present illness (HPI) 
• Past medical history (PMH) 
• Medications (Current and Previous) 
• Allergies 
• Family history