Healthcare, Legal & Specialized · community shared

Medical History Update Form — shared by the community

Yusuf E. shared this 12-question build with 4 conditional rules already wired up. Test it below, then take a copy.

A ready-to-use healthcare, legal & specialized form for teams with a niche process that generic forms don't cover: 12 questions, 1 page, 4 conditional rules.

Shared by
Yusuf E. · Recruitment partner
Questions
12
Replies
25
Copies taken
758
See the library version

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Live preview and test console

This is the real form. Answer it to test the 2 conditional rules — nothing is sent or stored.

Medical history update

This form does not provide medical advice, diagnosis or treatment. Information you share here is not a substitute for care from a qualified clinician. In an emergency, contact your local emergency service immediately.

2 questions are hidden by conditional logic right now — change an answer above to reveal them.

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

Who this template is for

Medical History Update Form is built for teams with a niche process that generic forms don't cover who need to capture reproducible detail on first contact.

  • Teams with a niche process that generic forms don't cover working in healthcare, legal & specialized.
  • Teams who need to capture reproducible detail on first contact without writing code or paying for a custom build.
  • Anyone replacing requests that need three replies before work can start with one structured record per enquiry.
  • Respondents are the specific group this workflow serves — the form asks them 12 questions across 1 screen.
  • Mobile-heavy audiences, thanks to the one-question-per-screen card layout.

Why this form is useful

It removes the cost of requests that need three replies before work can start and turns each submission into a record your team can act on immediately.

  • 6 questions are required, so submissions arrive complete instead of needing a follow-up email.
  • It pins the request to a specific date.
  • Conditional logic hides 4 questions until they are relevant — shorter forms convert better than long ones.
  • 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 Medical History Update Form 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 advanced show logic: if “Any new diagnoses?” is Yes, the form dynamically exposes “New diagnosis details”. Otherwise that question never appears.
  • Features conditional validation: if “Any new diagnoses?” is Yes, “New diagnosis details” becomes mandatory before the form can be sent.
  • Features advanced show logic: if “Medication changes?” is Yes, the form dynamically exposes “Current medication list”. Otherwise that question never appears.
  • Features conditional validation: if “Medication changes?” is Yes, “Current medication list” 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

What has changed

  • Patient namerequired
  • Date of birthrequired
  • Date of last visit
  • Any new diagnoses?required
  • New diagnosis details
  • Medication changes?required
  • Current medication list
  • New allergies?required
  • Hospital admissions since last visit?
  • Pregnancy status
  • Anything else to tell the clinician
  • Confirm the information is accuraterequired

Conditional logic in this build

  • WhenAny new diagnoses?is Yes, showNew diagnosis details”.
  • WhenAny new diagnoses?is Yes, requireNew diagnosis details”.
  • WhenMedication changes?is Yes, showCurrent medication list”.
  • WhenMedication changes?is Yes, requireCurrent medication list”.

Questions about this shared form

How often should this be sent?

Most clinics send it annually or before each routine appointment, whichever comes first.

Does this replace the full registration form?

No, it assumes a full registration already exists and only captures what has changed since.

What if a patient has had no changes at all?

They answer no to each question and it takes under two minutes, which is the point of keeping it short.

Should new allergies be verified by a clinician?

Yes, treat any new allergy answer as a prompt for a clinician to confirm details at the appointment rather than take it as final.

Is the Medical History Update Form template free to use?

Yes. You can preview and test Medical History Update Form 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 Medical History Update Form template ask for?

It asks 12 questions across 1 page, 6 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 Medical History Update Form form after copying it?

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

How does the conditional logic in this healthcare, legal & specialized form work?

4 conditional rules ship with the template: Features advanced show logic: if “Any new diagnoses?” is Yes, the form dynamically exposes “New diagnosis details”. Otherwise that question never appears. Features conditional validation: if “Any new diagnoses?” is Yes, “New diagnosis details” becomes mandatory before the form can be sent. Features advanced show logic: if “Medication changes?” is Yes, the form dynamically exposes “Current medication list”. Otherwise that question never appears. All rules are editable in the Logic tab.

Where do responses to the Medical History Update Form 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 Medical History Update Form 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.