Health Questionnaire Template
Collect accurate health information from individuals before programs, screenings, or appointments.
Whether you're running a fitness program, wellness screening, clinical intake, or workplace health initiative, you need accurate health information from participants before you can do anything useful with it. Collecting that information on paper, through email, or in a spreadsheet creates inconsistencies and makes it hard to act on what you've gathered.
A Typeform health questionnaire guides respondents through each section clearly, one question at a time. Conditional logic means someone who reports a chronic condition sees relevant follow-ups, while healthy individuals move through faster. You get complete, structured responses from everyone, with no blank fields and no follow-up chasing.
Customize the questionnaire for your specific context, whether that's a gym intake, an occupational health screen, or a community health program. Add your organization's branding and share via link or embed it wherever your audience will see it.
A health questionnaire is a structured form that collects information about an individual's medical history, current health status, lifestyle habits, and any conditions or medications relevant to a program, treatment, or assessment. It gives practitioners and program administrators a baseline understanding of each participant's health.
Structured health data is more reliable than information collected conversationally or after the fact. A consistent questionnaire ensures every participant provides the same categories of information, which makes it easier to identify risks, personalize services, and maintain accurate records.
Tailor it to your context, but typically cover:
- Current medical conditions and diagnoses
- Medications and supplements being taken
- Known allergies
- Recent surgeries, injuries, or hospitalizations
- Family medical history relevant to your program
- Lifestyle factors (physical activity, diet, smoking, alcohol)
- Current symptoms or areas of concern
- Emergency contact information
The template is fully customizable. A fitness intake will focus on exercise history and cardiovascular indicators. A workplace health screen might emphasize occupational hazards and musculoskeletal health. You can create separate versions for different programs while keeping the same base structure.
Make it clear in the form how data will be used and who has access to it. For clinical or regulated contexts, review your jurisdiction's health data privacy requirements and configure Typeform's access controls to restrict responses to authorized staff only.
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