Patient Encounter Form Template

Have doctors fill out this patient encounter form after each appointment to make sure they don’t forget a thing. That way, you’ll be sure the information is complete and correct.

No need to copy-paste all their answers into the correct patient file at the end of the day: our smart integrations take care of that on the fly.

On the contrary. You can easily tweak this template so it works for the processes in your medical office. It asks one question at a time, so doctors and medical staff won't risk forgetting to mention some vital information.

You can even upload additional files, like scans or test results, without using an extra tool. Plus, it is incredibly easy to use—even if you’re a little rusty on computers.

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. Do this 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.

Almost. File upload is on our paid plans. So if you want to keep it, you need to upgrade. If you don’t need file uploads, just delete that question. Without upgrading you can still play around with your form template, but to publish it with a File upload question you need to upgrade.