Online Patient Intake Forms

Eliminate messy paperwork while protecting health information with Jform’s HIPAA-friendly online patient intake forms. Collect payments, file uploads, e-signatures, and more. Get responses on any device.

템플릿

Free Patient Intake Form Templates

Create a custom form fast with ready-made patient intake form templates. Just customize a template to match your branding and share it to start collecting submissions!

Medical Patient Intake Form

Template 202373620102944

Plastic Surgery Patient Intake Form

Template 211263681444958

Coronavirus Suspected Patient Intake

Template 200772578426057

혜택

Create Patient Intake Forms

종이 서류 배제

Ditch paper and enjoy a more efficient way to collect patient intake forms. Jform helps you digitize your intake process and creates a secure online database of all your patients’ information.

Protect with HIPAA Compliance

Rest easy knowing that patient data is safe and secure. Opt into HIPAA compliance on our Gold, or Enterprise plans to get a signed Business Associate Agreement (BAA) and meet HIPAA requirements.

전자서명 수집

Get electronic signatures from any device. It’s a great way to cut down on paperwork and stop patients from having to print, sign, scan, and send their documents by hand.

모든 기기에서 작동

Jform’s online patient intake forms work seamlessly on any device — so your patients can enter their medical history, pay their bills, and sign documents from their own smartphone, tablet, or computer.

사용후기

Jform에 대한 사용자의 의견

Jform은 웹디자인 팀들에게 매우 편리한 도구입니다. 저희는 이것을 저희와 고객들의 사이트들을 위해 사용합니다. Jform은 디자인의 느낌이나 목적에 영향을 끼치지 않으면서 고객의 폼 목적을 지원해 줍니다. 연동과 자동화는 많은 시간을 절약해 줍니다. 저희는 필요한 만큼 폼과 그것의 기능들을 맞춤설정 합니다. 심지어 저희만의 HTML로 이메일 알림들을 설정할 수 있습니다. 저희는 지난 수년간 다른 폼 제공자들을 만났지만 Jform만큼 계속 발전하고 있지 않습니다. 계속 열심히 해주십시오!

Andrew Jones, 웹 디자이너, UpEngine