Healthcare form templates

Patient forms are administrative, and these templates treat them that way — collecting the information a front desk needs before a visit, with the conditional branches that keep them short for people with nothing to report.

15 templates · all free to use · live previews

Patient Intake

Contact details, visit reason, and insurance — done before you arrive.

9 questions
Appointment Booking

Visit type, patient status, and a live time-slot picker.

7 questions
Medical History

Conditions, allergies, medications, and surgeries with smart branching.

9 questions
New Patient Registration

Demographics, insurance, emergency contact, and pharmacy on file.

9 questions
Telehealth Consent

Video-visit disclosures, acknowledgments, and a binding signature.

8 questions
Therapy Intake

A gentle first step: what brings you in and what you hope to get out of it.

8 questions
Dental Intake

Visit reason, dental history, comfort level, and insurance details.

8 questions
Vaccination Consent

Vaccine selection, pre-screening checklist, and a signed consent.

8 questions
Patient Satisfaction Survey

Star rating, a care-experience matrix, and likelihood to recommend.

7 questions
Prescription Refill Request

Medication, prescriber, pharmacy, and urgency in one quick form.

8 questions
Physiotherapy Intake

Area of complaint, how it started, pain rating, and imaging — before the first session.

12 questions
Nutrition Consultation

Goals, dietary pattern, a typical day of eating, and what's realistic at home.

11 questions
Mental Health Screening

An intake and triage form — what's going on, how much it's affecting daily life, and how soon to call.

11 questions
Optometry Intake

Visit reason, current prescription, symptoms, and family eye history before the exam.

11 questions
Surgery Consent

Procedure details, point-by-point acknowledgments, outstanding questions, and a signature.

12 questions

What makes these forms work

Branch around the empty answers

Most patients have no allergies, no prior surgeries, and no current medication. Ask the yes/no first and only show the detail question when it applies — the form shrinks for the majority.

Send it before the appointment

An intake form completed at home is more accurate than one filled in on a clipboard while the waiting room fills up. Attach the link to your confirmation email.

Consent needs a signature and a date

Telehealth and vaccination consent forms should end with an e-signature question, which timestamps the agreement alongside the response.

Questions people ask

Are these forms HIPAA compliant?

Zunoform does not currently offer a HIPAA Business Associate Agreement, so these templates are intended for general administrative use rather than protected health information under HIPAA. If you need a BAA, choose a vendor that offers one.

Can patients book an appointment in the form?

Yes. The scheduler question shows real availability from your Google or Outlook calendar and prevents double-booking. It's on the free plan.

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