Healthcare & Clinical · community shared

Trial Enrollment Screening — shared by the community

Yusuf E. shared this 24-question build with 4 conditional rules already wired up. Test it below, then take a copy.

A ready-to-use healthcare & clinical form for small teams who need a reliable intake process: 24 questions, 3 pages, 4 conditional rules.

Shared by
Yusuf E. · Recruitment partner
Questions
24
Replies
17
Copies taken
342
See the library version

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Live preview and test console

This is the real form. Answer it to test the flow — nothing is sent or stored.

Page 1 of 3Study and basic criteria

Which study, and basic eligibility

How did you hear about the study?
Do you have the condition or characteristic this study is recruiting for?

This template runs as a straight sequence — no branching rules.

Works for you? Take Yusuf E.'s copy into your own workspace — questions, rules and settings included.

Who this template is for

Trial Enrollment Screening is built for small teams who need a reliable intake process who need to collect the same complete information from everyone.

  • Small teams who need a reliable intake process working in healthcare & clinical.
  • Teams who need to collect the same complete information from everyone without writing code or paying for a custom build.
  • Anyone replacing chasing missing details over email with one structured record per enquiry.
  • Respondents are the people you send it to — the form asks them 24 questions across 3 screens.
  • Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of chasing missing details over email and turns each submission into a record your team can act on immediately.

  • 15 questions are required, so submissions arrive complete instead of needing a follow-up email.
  • It pins the request to a specific date.
  • It allows multiple selections without free text.
  • Conditional logic hides 4 questions until they are relevant — shorter forms convert better than long ones.
  • Splitting the form across 3 pages keeps each screen short and shows respondents how much is left.
  • Every response is stored, searchable and exportable, so nothing depends on one person's inbox.

How to use this template

From copy to live form is a few minutes of work, and every step is reversible.

  1. 1Press “Use this template” — a fresh copy of Trial Enrollment Screening lands in your workspace, ready to edit.
  2. 2Rename or delete any question, and change what is required. Nothing here is fixed.
  3. 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
  4. 4Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
  5. 5Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.

Logic and conditions blueprint

Exactly how this form behaves as it is answered — 4 conditional rules ship with it.

  • Features conditional validation: if “Are you currently taking part in another study?” is Yes, “Which study, and when does it end?” becomes mandatory before the form can be sent.
  • Features conditional validation: if “Can you travel to the study site?” is No, “What would make attending possible?” becomes mandatory before the form can be sent.
  • Features conditional validation: if “Do you take any regular medication?” is Yes, “Medication and doses” becomes mandatory before the form can be sent.
  • Features conditional validation: if “May we contact you about this study?” is Yes, “Best way to contact you” becomes mandatory before the form can be sent.
  • All 4 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

What this form asks

Page 1 — Study and basic criteria

  • Study name or referencerequired
  • Full namerequired
  • Date of birthrequired
  • How did you hear about the study?required
  • Town or area you live inrequired
  • Do you have the condition or characteristic this study is recruiting for?required
  • Anything about that you want to explain

Page 2 — Health and treatment

  • Diagnoses you have
  • Do you take any regular medication?required
  • Medication and doses
  • Are you currently taking part in another study?required
  • Which study, and when does it end?
  • Have you taken part in research before?required
  • Are you under the care of another service at the moment?required
  • Allergies and what happens on exposure

Page 3 — Availability and contact

  • Can you travel to the study site?required
  • What would make attending possible?
  • Could you attend several visits over the study period?required
  • Would you need time away from work or study?required
  • Who could come with you if needed?
  • Understandingrequired
  • May we contact you about this study?required
  • Best way to contact you
  • Questions you would like answered before deciding

Conditional logic in this build

  • WhenAre you currently taking part in another study?is Yes, requireWhich study, and when does it end?”.
  • WhenCan you travel to the study site?is No, requireWhat would make attending possible?”.
  • WhenDo you take any regular medication?is Yes, requireMedication and doses”.
  • WhenMay we contact you about this study?is Yes, requireBest way to contact you”.

Questions about this shared form

How is this different from the Research Study Screening Form?

That one is a general study screener. This is written for trial enrolment specifically, with the treatment, other-study and visit-availability questions a trial protocol usually requires.

Does completing this form enrol someone?

No. It is an enquiry and screening record. Informed consent for the trial is a separate documented conversation, and the form says so before the contact question.

Can it be used before ethical approval is in place?

No. Recruitment materials and screening forms normally require approval alongside the protocol, so confirm your approvals before publishing it.

How should screening data be retained?

Follow the retention terms in your approved protocol, including for people who were screened but never enrolled, and set that schedule before recruitment opens.

Is the Trial Enrollment Screening template free to use?

Yes. You can preview and test Trial Enrollment Screening on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.

What does the Trial Enrollment Screening template ask for?

It asks 24 questions across 3 pages, 15 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.

Can I edit the Trial Enrollment Screening form after copying it?

Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, restyle it to match your brand, and set who gets notified on each submission.

How does the conditional logic in this healthcare & clinical form work?

4 conditional rules ship with the template: Features conditional validation: if “Are you currently taking part in another study?” is Yes, “Which study, and when does it end?” becomes mandatory before the form can be sent. Features conditional validation: if “Can you travel to the study site?” is No, “What would make attending possible?” becomes mandatory before the form can be sent. Features conditional validation: if “Do you take any regular medication?” is Yes, “Medication and doses” becomes mandatory before the form can be sent. All rules are editable in the Logic tab.

Where do responses to the Trial Enrollment Screening form go?

Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.

Can I embed the Trial Enrollment Screening form on my own website?

Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.