Free Form Templates

Medical History

Medical history form template for collecting symptoms. Your patients can use this medical history form to submit their symptoms and receive a complete diagnosis by email or phone. Each time someone submits your medical history form, you'll be notified by email. You can manage all entries in your data table and activate SMS notifications when out of the office.

Free Form Builder with Free Medical History Template
  • Available for all plans
  • Publish it anywhere on the Web
  • Take full control of your entries
  • Add your own style and colors

This is how the template looks like

Use this Medical History template

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