Employee Medical History Template

About this template

Gathering your patients' medical information may be a troublesome task. But you can collect these medical data with this medical history form template and you can record these data easily as a pdf with this medical history PDF template that was created by us by using Jotform's new PDF editor.

Firstly, you can collect personal information from your patients with this medical history form template. For example full name, phone number, gender. Also, you can collect medical information such as conditions that apply to your patients, symptoms that they're experiencing, medications that they're using, their medication allergies, a frequency of alcohol consumption.

Thereafter, you can transfer the data into Jotform's new PDF editor. You can easily use this medical history PDF template to record the data as a pdf. Additionally, Jotform offers features to assist your HIPAA compliancy in appropriate plans for reinforcing your security.

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These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.