Patient intake forms can be extensive, time-consuming, and even overwhelming for patients to complete, especially when filling them out in the clinic. However, accurate and complete information is critical to providing quality care.
That’s why an online patient intake form can be so effective. You can craft the form to capture all of the details you need from your patients, and allow them to submit their information from the comfort of their own homes.
Use our patient intake form template to efficiently collect patient medical histories, vaccination records, allergies, emergency contact information, and more. Plus, the intuitive SurveyMonkey form builder allows you to adapt the form to your practice's needs while incorporating branding elements for a professional touch.
We have so many powerful features to help you launch surveys quickly, but here are our most popular ones for new users.
Out-of-the-box themes, accessible color palettes, custom fonts, branding, and more.
Collect survey responses via email, website, SMS, social media, QR codes, offline, and more.
Automatic results summaries, filters, custom dashboards, crosstab reports, text analysis, & more.
Read about our customers, explore webinars, and get guides on collecting feedback in your industry.
Get tips on how to create better surveys, hear the latest product news, or check out our research.
Access tutorials on how features work, learn more about billing, and contact Customer Support.
Healthcare leaders can use this toolkit to help better understand the patient and employee experience.
Discover how Carrot relies on SurveyMonkey for HIPAA-compliant surveys, improved data collection, and better clinical outcomes.
How do surveys and forms differ? Learn how to combine form data with survey feedback for seamless events and experiences.
An efficient patient registration process makes onboarding easy and saves time. But what do you need to collect, and how? We can help.