Medical History Form

Free trial

Streamline the patient registration process and save time both for patients and administrative staff by taking your patient medical history forms online. The Medical History Form Template from Formsite makes it easy to gather health history from new patients and update medical records for current patients. This user-friendly online form can be accessed from any device, so patients have the ability to complete their medical forms online before their appointment, or even on a tablet in the waiting room. Administrative staff is notified as soon as a new form has been submitted and form data can be exported to sync with office medical information software. It is a quick and efficient way to make sure your medical charts are up-to-date with each patient’s medical history.

The Medical History Form Template is simple to customize for any hospital or practice. Add or modify form fields on the medical history template to collect the information that you need. Form fields can include things like patient contact information, emergency contact phone number, family medical history, personal medical history, prior medical care, allergic reactions, blood pressure concerns, health insurance, and more. HIPAA compliance options are available to protect patient information.

Formsite specializes in making online forms easy. We offer simple solutions to your most advanced problems. Whether you need to gather health history, a simple patient registration form, or something more complex, we have an online form that can help. We also offer enterprise level solutions to meet the needs of larger medical organizations. Get started today.

Medical History Form

Why Formsite

The world-class no-code form and survey builder.

Fully-featured and easy-to-use form builder since



of templates to choose from to get you started

$500 million

in payments processed to date


of forms submitted to date


online form integrations

Customer support based in


Thousands of brands trust Formsite

Be the next one.