Patient Registration Form

Medical rooms, private practices, clinics & hospitals use the new patient forms to register patients into their medical facility’s system so they can provide proper care. Patients can fill it out on their digital device and have it ready before their first appointment. It helps healthcare workers complete the patient registration process ahead of time and speed up the entire intake process.

What is a Patient Registration Form?

The patient registration form is a document that helps healthcare staff collect personal and health information from new patients and register them. Whether it’s primary care or acute care, you want to shorten the waiting time in the medical room and provide safe and effective medical assistance. With 123FormBuilder’s sample, you can collect the patient’s data online and have their medical records ready upon arrival at your facility. While these forms are widely used in healthcare settings, they can also serve well to organizations that potentially handle medical data, such as schools or sports leagues.

What Information is Needed for a New Patient?

When registering new patients in your system, these are some of the information you need to collect:

1. Contact details
2. Demographic information
3. Basic health information (medical condition, medications, health history, family health history, etc.)
4. Insurance information (insurance card, billing info, etc.)
5. Past medical records (diagnostic reports, medical releases, etc.)

HIPAA Compliant Patient Form

To make a new patient registration form HIPAA compliant, you only need a 123FormBuilder account. 123FormBuilder is 100% HIPAA compliant. This means that with an Enterprise plan, you can activate the HIPAA option and enjoy the advanced security measures. That protects the ePHI you collect with our HIPAA-compliant forms.

Benefits of Using a Secure 123FormBuilder Template

If you need a quick and easy way to register new patients, 123FormBuilder patient forms can help you collect data safely and securely without wasting precious time.

Customize template

Start from scratch or grab a template from the 123FormBuilder patient forms gallery and start customizing it using our drag&drop editor. Style it according to your brand, rearrange fields, add your logo, and even a signature field (in case you’re building consent forms). And when you’re done, just hit enter, and that’s it. You don’t need any coding skills, so you can have it ready to use in just a few minutes. Make it easy for patients to complete it and for you to assess the data.

Collect & Manage Data Safely

Once it’s ready, share the form on your website, include it in your online patient packet, send it via e-mail, and collect data. Rely on 123FormBuilder’s strong security measures and HIPAA compliance to protect the privacy and integrity of ePHI.

Optimize processes

Any completed form that a healthcare provider gets before the appointment is a step forward to a smoother healthcare experience. Using 123FormBuilder’s patient forms allows you to collect data accurately. Also, you can reduce the risk of human error and provide easy access to medical records.

Are You Looking For a Different Health Template?

We have over 270 patient & medical forms to choose from!