Doctor visit form template

With Typeform, it couldn't be simpler. Start with our free template and customize it to your heart's content. You can edit the design, colors, and fonts, and even add different questions and images to make it your own.

Plug the form into your most-used apps, so responses arrange themselves as they come in. When the form's finished, click publish, then spread it far and wide. Share the link across social media or embed it into your website, and you're good to go.

This online form—plus the integrations it comes with—helps you get organized. Once you've collected submissions, simply click export and automatically download an organized spreadsheet or CSV file full of form data.

Or you can take your data management up a level with our smart integrations. With these, you can automatically send the data straight to Google Sheets, Trello, Airtable, or one of our other apps. Save tons of copy-paste time and spend more time on things that matter.

Before you send out your form, there are two things you should do:

1. 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.

1. 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.