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Health Questionnaire Template

✓ No credit card required
✓ No time limit on Free plan

National Health QuestionnairePlease read the following statements and tick the relevant box

I eat healthily

I smoke

I exercise

I drink alcohol

How much exercise do you do per week?

None

Less than 5 hours

5-10 hours

10-20 hours

More than 20 hours

How well do you sleep, on average?Do you have any illnesses or conditions?What's your date of birth?How do you identify?

Female

Male

Non-binary

Prefer not to say

Thanks for completing our questionnaire!

Rated 4.5 out of 600+ reviews on G2.com

A straightforward way to gather important health info

People are more likely to complete your health questionnaire when it's easy to use, short, and can be completed on any device. Our questionnaires look and feel great, and can be filled out any time, anywhere

Health questionnaire FAQs:

Our forms are completely customizable, so it's up to you. We'd start by having a clear objective for your questionnaire's outcome, so you can plan your questions carefully.

You can get specific and ask about healthy eating habits or go even broader, with questions that cover all areas of health.

With Typeform, you can add and edit the questions to suit your needs, and make use of our range of question types. Check out our free template to get started.

First rule of thumb—don't overwhelm respondents. Only ask what's necessary, and try to keep it under ten questions.

Luckily, typeforms are built to provide a great user experience. They only ask people one question at a time, so it's more engaging and encourages more thoughtful responses.

Keep things interesting by using a range of question types. We've got lots to choose from, from Multiple Choice to Matrix, Dropdowns to Ratings, and everything in between. You can even use Long Text questions to collect in-depth qualitative info.

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.

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

Make life easy with integrations

Google Sheets

Salesforce

Slack

Google Analytics

Zapier

HubSpot

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

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study
Kate Donhoe
Head of Product Marketing

Leads from the Typeform integration were twice as likely to convert.
Tobias Wasmer
Marketing Manager @ Volvo Cars

You used to need developers to do all this. Not anymore.
Kyle Maltz
Chief Operating Officer

Typeform is a production-grade system for our entire growth funnel.
Gaurav Vohra
Head of Growth

Typeform helps me attract more responses and a higher response rate than other tools.
Rand Fishkin
CEO + Founder

Form builders are as old as the web, but Typeform elevates the medium substantially.
Johnny Rodgers
Product Architect

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study
Kate Donhoe
Head of Product Marketing

Leads from the Typeform integration were twice as likely to convert.
Tobias Wasmer
Marketing Manager @ Volvo Cars

You used to need developers to do all this. Not anymore.
Kyle Maltz
Chief Operating Officer

Typeform is a production-grade system for our entire growth funnel.
Gaurav Vohra
Head of Growth

Typeform helps me attract more responses and a higher response rate than other tools.
Rand Fishkin
CEO + Founder

Form builders are as old as the web, but Typeform elevates the medium substantially.
Johnny Rodgers
Product Architect

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study
Kate Donhoe
Head of Product Marketing

Leads from the Typeform integration were twice as likely to convert.
Tobias Wasmer
Marketing Manager @ Volvo Cars

You used to need developers to do all this. Not anymore.
Kyle Maltz
Chief Operating Officer

Typeform is a production-grade system for our entire growth funnel.
Gaurav Vohra
Head of Growth

Typeform helps me attract more responses and a higher response rate than other tools.
Rand Fishkin
CEO + Founder

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 intuitive builder.

Choose from different question types: Multiple Choice, Rating, Opinion Scales, and more.

Take respondents down different paths based on their answers.

Health questionnaire not right?

1500+ Templates, 120+ Integrations

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Find out who your customers are and what they're using your product for

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Developing a product? Find out more about your target audience with this survey

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Discover new insights for your market fit

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Get insights to navigate the market and build your brand

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Use insights you get from this survey to fuel product growth

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Customer Feedback Form Template

Beautiful, fun, easy to complete. Comes with useful rating questions

Learn more

Other categories used by people like you

Order forms Application forms Feedback forms Lead Generation Quizzes Feedback surveys Customer satisfaction surveys File upload forms Evaluation forms Job application forms Marketing surveys Event forms Event surveys

Health Questionnaire Template

A straightforward way to gather important health info

Health questionnaire FAQs:

What should I ask in my health questionnaire?

How do I create a good questionnaire?

What should I consider before using this healthcare form?

Make it uniquely yours

Make life easy with integrations

Here's what people say about us

How does it work?

Health questionnaire not right?

Other categories used by people like you