How to Create a Medical Online Form

A medical online form can gather really easily all the important information about a person’s medical history. If you (or the client for whom you’re creating the website) provide services in the medical industry, such a web form can show that you are concerned with the medical condition of patients, in order to provide the best medical service possible. An online form of this type is a very practical tool – it is easy to fill out and collected data can be managed in various ways. You just need to sign up for an account on a free online form and survey builder and customize the online medical form template.

Build a Medical Online Form

Select the medical history form template and customize it. Add new form fields to get all the information that you find relevant. The medical online form template starts by asking for the patient’s name and contact number. Then, respondents are requested to check the medical conditions that apply to them or any of their immediate relatives in a checkbox list that includes the most common serious conditions. The patient is then asked to tick the symptoms that they are experiencing at present.

The medical online form then continues by asking whether respondents are under any medication, whether they have any allergies to medication and what their gender is. These are special form fields. If the answer is affirmative for the first to questions or Female for the third one, then new fields show up, asking what medication respondents are under, what allergies they have or whether they are pregnant. If answers are negative or the patient is a male, then the additional fields remain hidden, in order to avoid redundancy. This is done with field rules. Finally, the medical online form inquires into reposondents’ habits with respect to tobacco, illegal drugs and alcohol.

Build a Medical Online Form

When you’re done customizing the form structure, you can move on and customize a form theme. After that, publish the medical form on the web: on the website, on Facebook, on WordPress or send it as direct links via email or messenger to patients.

After respondents fill out the form, you can view medical records online, in the database of the form builder that you used or in your mailbox. You can also export medical records to Excel files or to Google Docs spreadsheets. What is more, you can integrate the form with 3rd party apps, like MailChimp, to have form users’ names and contact data sent to your MailChimp mailing lists.

Have a look at other free form templates.

This entry was posted on Thursday, January 5th, 2012 at 12:03 pm and is filed under Business Forms, Online Surveys. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.

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