Patient health history questionnaire

Instead of a page full of cumbersome questions, boxes too small to write in and confusing wording, this questionnaire asks your patients one question at a time—the same way you would face-to-face. This helps them to focus and give better answers, for a stress-free process. So it’s a better experience for them, and better for you as you’ll get the info you need to provide a helpful and efficient service.

human error. There’s no need to create files by hand every time you meet a new patient. Typeform’s integrations automatically turn new responses to this questionnaire into files in Google Docs, Office 365, Dropbox, and other tools and applications you may use to manage documents.

Before you send out your form, there are two things you should do:

1. Set up a BAA (Business Associate Agreement) with us

Typeform is a HIPAA-compliant company, so all the healthcare-related info you process with us is legally airtight. But for you to be 100% HIPAA compliant, you’ll first need to set up a BAA. To do this you would need to talk to us about our enterprise plan, which you can do by filling out this Typeform, or contacting your Typeform account manager.

1. Check the local data collection laws

Data collection laws aren’t a one-size-fits-all thing—especially when there’s sensitive medical info involved. So before hitting share, seek advice from a local lawyer to make sure you’ve covered everything.