Doctor Visit Form Template

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A simpler way to keep your records up-to-date

This doctor visit form helps patients request appointments and update their medical records in just a few clicks. And the integrations that come with it manage your data automatically. So patients get a smoother visit, and you get less paperwork.

Doctor visit form FAQs:

1. How do I create a doctor visit form?

With Typeform, it couldn't be simpler. Start with our free template and customize it to your heart's content. You can edit the design, colors, and fonts, and even add different questions and images to make it your own.

Plug the form into your most-used apps, so responses arrange themselves as they come in. When the form's finished, click publish, then spread it far and wide. Share the link across social media or embed it into your website, and you're good to go.

2. How do I manage patient data with a form?

This online form—plus the integrations it comes with—helps you get organized. Once you've collected submissions, simply click export and automatically download an organized spreadsheet or CSV file full of form data.

Or you can take your data management up a level with our smart integrations. With these, you can automatically send the data straight to Google Sheets, Trello, Airtable, or one of our other apps. Save tons of copy-paste time and spend more time on things that matter.

3. What should I consider before using this healthcare form?

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.

Make it uniquely yours

Make it uniquely yours

Customize to your heart's content: backgrounds, Google fonts, colors, buttons, and more.

Choose from thousands of beautiful images, videos and icons. Or use your own.

Create beautiful forms with zero coding required

Get started — it's free

Here's what people say about us

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro

Form builders are as old as the web, but Typeform elevates the medium substantially.

Johnny Rodgers

Product Architect

Slack

We’ve received 3x the responses using Typeform than from a professionally commissioned market research study

Kate Donhoe

Head of Product Marketing

Pitch

Leads from the Typeform integration were twice as likely to convert.

Tobias Wasmer

Marketing Manager @ Volvo Cars

Volvo

You used to need developers to do all this. Not anymore.

Kyle Maltz

Chief Operating Officer

Dollar Flight Club

Typeform is a production-grade system for our entire growth funnel.

Gaurav Vohra

Head of Growth

Superhuman

Typeform helps me attract more responses and a higher response rate than other tools.

Rand Fishkin

CEO + Founder

SparkToro
Collect 18% more data with Typeform compared with our two main competitors in the market

How does it work?

Make a stylish form in minutes with our drag-and-drop builder.

Choose from different question types: multiple choice, rating, opinion scale, free-form text, and more.

Take respondents down different paths based on their answers.

Doctor visit form not right?

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