Health Evaluation Form Template

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The all-in-one tool for running pulse checks on your people

Whether you're assessing the wellbeing of patients, students, or employees, this online health evaluation form can flex to fit your needs. Say goodbye to paper forms, emails, and manual errors. Instead, say hello to automated admin tasks, seamless workflows, and lots more free time.

Health evaluation form FAQs:

1. How do I collect health evaluation data?

You'll be pleased to know, this powerful online form does most of the hard work for you.

Our pre-made template is a great place to start. We've included some key questions in here (all tied together with a slick design), so you can use what's there or customize it to suit you.

Our forms are mobile-friendly and come pre-designed, so you don't need to worry about coding or making it look good. When your form's finished, simply click 'publish' and start sharing—you can easily embed it into your website or intranet, share the link directly, or embed it into an email.

When responses come in, our integrations can organize them for you. Bring data to life with a Google Sheets integration, send follow-up emails with a Mailchimp integration, and let Google Drive sort responses into folders. And that's just the start.

2. What is a health evaluation form?

Health evaluation forms are typically used by medical centers or doctors taking on new patients. They might also be used by companies or sports clubs, for emergency or insurance reasons.

These evaluation forms are great for gathering sensitive data in a secure, efficient way. And with this template, you can collect as little or as much info as you like, thanks to our flexible form builder.

We'd recommend starting with the basics, like name, date of birth, and address—the key stats you'll want on file. Then, it's up to you. You can find out what medication people are taking, and if they have any underlying health conditions. You can even get people to rate their current physical and mental health using an Opinion Scale question type.

Make it uniquely yours

Make it uniquely yours

Customize to your heart's content: backgrounds, Google fonts, colors, buttons, and more.

Choose from thousands of beautiful images, videos and icons. Or use your own.

Create beautiful forms with zero coding required

Get started — it's free

Here's what people say about us

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro
Collect 18% more data with Typeform compared with our two main competitors in the market

How does it work?

Make a stylish form in minutes with our drag-and-drop builder.

Choose from different question types: multiple choice, rating, opinion scale, free-form text, and more.

Take respondents down different paths based on their answers.

Health evaluation form not right?

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