New Patient Registration Form Template

Make it convenient for patients to provide important information fast—whether they’re already on-site or are at home preparing for the first appointment. With options like Social Autofill and field validation, you can easily collect contact information, primary care data, pharmacy details, and more. Start with the included form fields and customize them to meet your needs.

Accept patient data online without worry. With special features designed especially for healthcare providers, you can collect, store, and distribute patient data in a HIPPA compliant manner—and even export it to third parties using HIPAA compliant integrations with this new patient registration form template. To streamline further, use this template along with Formstack’s medical release and medical history forms.

Make sure new patient information is placed in the right hands, at the right time. Advanced Data Routing and Conditional Logic features can be used to ensure new form submissions are sent to specific employees, roles, or departments. Simply decide what you want to have happen after a form is submitted, and data will be automatically routed based on the criteria you set.

Formstack’s new patient registration form eliminates the need to print, scan, or email hand-collected signatures. Collect electronic signatures or use Formstack Sign to collect digital signatures and they’ll be saved as image files in our secure database for future reference. Patients can sign your form from any device, too—smartphones, tablets, and laptops included. It’s the easiest, fastest method available today.