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Full patient history form online templates
48 free full patient history form online templates you can preview without an account. They span Healthcare & Clinical, Healthcare, Legal & Specialized, Pets & Veterinary use cases and average around 17 questions each, so most teams find one that only needs light editing. Open any template to see every question it asks, the conditional logic it ships with, and the layouts it supports — then publish it on your own link, embed it on your site, or share it by QR code. Submissions land in your HelloForms inbox with email notifications, exports and analytics from the first response.
48 templates for “full patient history form online”
Patient History Form
Full three-part medical history: personal and family background, systems review, lifestyle and medication, ready before a first consultation.🏥 Healthcare & Clinical24 questionsMedium length — 24 questions across 3 pages.View templatePatient Satisfaction Form
Fuller patient survey covering access, reception, facilities, the consultation, communication and whether the patient would recommend the clinic.🏥 Healthcare & Clinical17 questionsShort form — 17 questions across 2 pages.View templateDental New Patient Intake Form
Dental history, insurance and consent in one pre-visit pack for new patients.🩺 Healthcare, Legal & Specialized20 questionsShort form — 20 questions across 4 pages.View templatePatient Intake Form
Medical history and background disclosure with a compliance focus.🩺 Healthcare, Legal & Specialized20 questionsShort form — 20 questions across 3 pages.View templateNew Patient Registration Form
Complete new-patient record: contacts, history, medications, insurance and consents.🩺 Healthcare, Legal & Specialized20 questionsShort form — 20 questions across 3 pages.View templateChiropractic Intake Form
New patient intake for chiropractic care: the complaint and its history, previous manual treatment, general health screening, and consent to treat.🏥 Healthcare & Clinical19 questionsShort form — 19 questions across 2 pages.View templateMedical History Form
Collect conditions, medication, allergies, surgeries and family history before an appointment.🩺 Healthcare, Legal & Specialized23 questionsMedium length — 23 questions across 5 pages.View templatePatient Referral Form
Clinician-to-clinician referral with the reason for referral, relevant history, what has been tried, urgency and what the referrer is asking for.🏥 Healthcare & Clinical19 questionsShort form — 19 questions across 2 pages.View templateMedical History Update Form
The short annual refresh: what changed since the last visit, without repeating full intake.🩺 Healthcare, Legal & Specialized12 questionsShort form — 12 questions on a single page.View templateDermatology Patient Intake Form
Dermatology intake covering the reason for the visit, how long it has been present, skin history, sun exposure and current skincare products used.🏥 Healthcare & Clinical15 questionsShort form — 15 questions across 2 pages.View templateFall Risk Assessment Form
Fall risk assessment recording fall history, mobility and balance, medications, vision, and home hazards, with a plan for follow-up and referrals.🏥 Healthcare & Clinical16 questionsShort form — 16 questions across 3 pages.View templateTherapy Client Intake Form
Counselling intake covering history, goals, medication and emergency contact.🩺 Healthcare, Legal & Specialized19 questionsShort form — 19 questions across 4 pages.View templateVeterinary New Patient Intake Form
Register a new animal patient with owner, species and medical history.🐾 Pets & Veterinary27 questionsMedium length — 27 questions across 4 pages.View templateDental Registration Form
New dental patient sign-up with contact details, insurance, dental history and a treatment consent line.🧘 Fitness, Wellness & Coaching16 questionsShort form — 16 questions across 3 pages.View templateMedication Review Form
A structured review of everything a patient takes, how well they are managing it, the side effects they notice, and what they would like changed.🏥 Healthcare & Clinical16 questionsShort form — 16 questions across 2 pages.View templateNutrition Intake Form
Dietetic intake covering what the patient eats in a typical day, symptoms, relevant conditions and medication, and the goal they want to work on.🏥 Healthcare & Clinical19 questionsShort form — 19 questions across 2 pages.View templateConsent to Treatment Form
Records informed consent for a specific procedure: what was explained, alternatives discussed, questions answered, and the patient's signature.🏥 Healthcare & Clinical19 questionsShort form — 19 questions across 2 pages.View templateDental Treatment Plan Consent Form
Dental treatment plan consent that lists recommended procedures, costs, alternatives discussed, and the patient's signed agreement before work begins.🏥 Healthcare & Clinical14 questionsShort form — 14 questions across 2 pages.View templateLab Test Requisition Form
Lab test requisition recording the ordering clinician, tests requested, reason for testing, fasting needs and the patient's preferred lab location.🏥 Healthcare & Clinical11 questionsShort form — 11 questions on a single page.View templateOrthodontic Consultation Form
One-page form for a first orthodontic consultation: main concern, prior treatment, jaw symptoms, and the times that suit an initial appointment.🏥 Healthcare & Clinical12 questionsShort form — 12 questions on a single page.View templatePatient Intake Questionnaire
Pre-appointment intake in two parts: contact and cover details, then reason for attending, current medication, allergies and relevant history.🏥 Healthcare & Clinical18 questionsShort form — 18 questions across 2 pages.View templatePediatric Intake Form
Child intake completed by a parent: birth and development history, immunisations, current concerns, school and family context, and consent to treat.🏥 Healthcare & Clinical28 questionsMedium length — 28 questions across 3 pages.View templatePharmacy Transfer Request Form
Pharmacy transfer request naming the current and new pharmacy, every prescription to move, and the patient's authorization for the new pharmacy to request them.🏥 Healthcare & Clinical11 questionsShort form — 11 questions on a single page.View templateCaregiver Assessment Form
Caregiver assessment recording caregiving hours and tasks, existing support, personal impact, and the services a caregiver wants more information about.🏥 Healthcare & Clinical14 questionsShort form — 14 questions across 2 pages.View template
Showing 24 of 48 templates
All 48 full patient history form online templates
- Patient History Form
- Patient Satisfaction Form
- Dental New Patient Intake Form
- Patient Intake Form
- New Patient Registration Form
- Chiropractic Intake Form
- Medical History Form
- Patient Referral Form
- Medical History Update Form
- Dermatology Patient Intake Form
- Fall Risk Assessment Form
- Therapy Client Intake Form
- Veterinary New Patient Intake Form
- Dental Registration Form
- Medication Review Form
- Nutrition Intake Form
- Consent to Treatment Form
- Dental Treatment Plan Consent Form
- Lab Test Requisition Form
- Orthodontic Consultation Form
- Patient Intake Questionnaire
- Pediatric Intake Form
- Pharmacy Transfer Request Form
- Caregiver Assessment Form
- Eye Exam Intake Form
- Mental Health Intake Form
- Quick Cancellation Form
- Records Release Form
- Care Plan Review Form
- Medical Equipment Loan Request Form
- Physiotherapy Intake Form
- Pre-Surgery Assessment
- Substance Use Screening Form
- Quick Patient Check-In
- Quick Patient Registration
- Discharge Follow-Up Form
- Nurse Triage Form
- Occupational Health Form
- Research Study Screening Form
- Quick Symptom Report
- Quick Vaccination Record
- Trial Enrollment Screening
- Home Health Assessment
- Advance Directive Questionnaire
- Clinic Appointment Request
- Pain Assessment Questionnaire
- Quick Records Request
- Quick Refill Request
Frequently asked questions
- Are these full patient history form online templates free?
- Yes. Every full patient history form online template on this page is free to preview and free to use on the Starter plan, including your own public form link and email notifications on each submission.
- Which full patient history form online template should I start with?
- Patient History Form is the closest match for this search — it has 24 ready-made questions. If it asks for more than you need, delete any question in the builder; nothing is locked.
- Can I change the questions on a full patient history form online template?
- Every question is editable. Rename labels, mark fields required or optional, add conditional logic so follow-up questions only appear when they are relevant, and restyle the form to match your brand.
- How do I collect responses?
- Publish the form and share its link, embed it in a page, or print its QR code. Responses appear in your inbox in real time and can be exported to CSV or PDF at any time.
Related templates
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Clinic Appointment Request
Appointment request that gathers the reason for the visit, urgency, clinician preference and real availability so the diary can be filled in one reply.🏥 Healthcare & Clinical16 questionsShort form — 16 questions across 2 pages.View templateQuick Patient Check-In
One-screen arrival form for the waiting room: identity confirmed, reason for the visit noted, and any change since the last visit flagged for the clinician.🏥 Healthcare & Clinical9 questionsShort form — 9 questions on a single page.View templateMental Health Intake Form
Three-page intake for mental health services: presenting concerns, history and support, risk and safety questions, and what the client wants from therapy.🏥 Healthcare & Clinical25 questionsMedium length — 25 questions across 3 pages.View templateQuick Refill Request
Single-screen repeat prescription request with medication and dose, preferred pharmacy, collection or delivery and a note for the prescriber.🏥 Healthcare & Clinical10 questionsShort form — 10 questions on a single page.View templatePre-Surgery Assessment
Pre-operative assessment covering fitness, anaesthetic history, medication to stop or continue, fasting instructions and arrangements for going home.🏥 Healthcare & Clinical27 questionsMedium length — 27 questions across 3 pages.View templateNurse Triage Form
Clinician-completed triage record: the presenting problem, observations taken, red flags checked, the advice given, and the disposition decided.🏥 Healthcare & Clinical17 questionsShort form — 17 questions across 2 pages.View template
