Patient registration form template
Collect patient info through an online form and say goodbye to piles of paperwork
Collect up to 3.5x more data with Typeform
With Typeform, you can customize everything
Change text, colors, and even logos to match the look and feel of your brand. Then embed forms smoothly onto web and email.
Make forms feel effortless to fill out. Pace questions, call people by their name, and adapt the flow based on the data they share.
Stay efficient by connecting forms to your workflow. Typeform integrates with 300+ tools including Slack, Zapier, and HubSpot.
An online registration form helps you save time, boost productivity and keep patients happy. Send patients a link to the form when they arrive, and they can fill it out in the waiting room before their appointment. And thanks to our smart integrations, all your patients’ info can be directed to a spreadsheet where it’ll organize automatically.
No more sifting through piles of pages or manually importing data. With a typeform, you can significantly reduce paperwork and patient wait time—better for your staff, better for patients and better for the planet.
Before you send out your form, there are two things you should do:
- Set up a BAA (Business Associate Agreement) with us
Typeform is a HIPAA-compliant company, so all the healthcare-related info you process with us is legally airtight. But for you to be 100% HIPAA compliant, you’ll first need to set up a BAA. To do this you would need to talk to us about our enterprise plan, which you can do by filling out this Typeform, or contacting your Typeform account manager.
- Check the local data collection laws
Data collection laws aren’t a one-size-fits-all thing—especially when there’s sensitive medical info involved. So before hitting share, seek advice from a local lawyer to make sure you’ve covered everything.
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