Streamline the intake of suspected coronavirus patients with Formstack’s COVID-19 patient intake form. This template includes fields that can help you gather patient information such as insurance details, COVID-19 specific symptoms, and emergency contacts.
This COVID-19 intake form template is 100% customizable. With the help of Formstack’s drag-and-drop builder, it will only take you a few minutes to add your branding and tweak the form to better fit the needs of your organization.
Keep patients and staff safe with a contactless experience. Easily embed this intake form on your website, share it with patients via email, or collect data using an in-office tablet. Formstack’s mobile-optimized forms make it easy to gather information from any device.
Formstack offers HIPAA-friendly features that can help you achieve compliance. Safely collect sensitive patient data with security measures that include advanced data encryption, user-level permissions, audit logging, and dedicated security maintenance.
Connect your COVID-19 intake form template to the tools your team uses every day. With dozens of integrations to choose from, you can send information to spreadsheets, route data to an outside cloud storage platform, collaborate in Salesforce, and much more.