Patient Demographics Form

Keep all patient information in your database up to date with the Patient Demographics Form Template from Formsite. This user-friendly form makes it easy to collect patient demographic data, along with any other patient health information you may need to provide the best care. Using an online form means that patients can fill out demographic information at their convenience, instead of trying to get through a stack of paper forms at appointment time. All forms are mobile-friendly, so patient demographic forms can be completed on any device. You can even choose to use tablets to replace patient information forms in your office. Online forms streamline the patient intake process for health care providers and their teams.

This demographics form template is simple to customize, so that you can gather all the information you need. Use this form during patient registration to gather additional knowledge beyond medical history. Choose form fields like date of birth, primary care physician, marital status, full-time/part-time employment status, family member information and more. HIPAA compliance capabilities are available. The Patient Demographics Form Template is a great compliment to other important patient forms that you can build with Formsite. Try our health history template, hospital discharge form template and more.