New Patient Registration Form Template

Streamline your patient onboarding process with this simple New Patient Registration Form template. Use this free template to enhance your intake process, improve patient data collection, and ensure a smooth experience for new patients.

Customize in minutes

Drag and drop 40+ customizable question types to make this template your own.

Scheduling

Calendly, Chili Piper, cal.com

File uploads

Securely collect documents

Email address

Work or personal

Mailing address input

Autocomplete with the Google Maps API

Collect phone numbers

Domestic or international

Captcha

Verify human respondents

+ dozens more

Connect to
Notion

Send responses wherever you need them, in 60 seconds:

1Clone this template.

2Connect your integration in Fillout.

3Share a link or embed forms anywhere ⚡️

Template FAQs

Why choose the New Patient Registration Form template?: Digitize your patient intake process and save time during onboarding. Offer a seamless experience for new patients from the very beginning.
Can I customize the New Patient Registration Form template?: Absolutely! Personalize the form with your clinic's branding and colors. Collect the exact patient information you need for a smooth registration process.
Does the New Patient Registration Form template integrate with other tools?: Yes, you can easily connect the form to your CRM for streamlined patient management. Integrate with scheduling software or a payment processor for added convenience.
Is the New Patient Registration Form mobile-friendly?: Definitely! The form is designed to work perfectly on any device, ensuring a user-friendly experience for patients registering on-the-go.
Are all features on the New Patient Registration Form template free?: Yes, the basic features are completely free. Explore additional options for premium features and enhancements to further streamline your patient registration process.
How do I get started with the New Patient Registration Form template?: Start by cloning the template and customizing it to meet your clinic's specific needs. Easily embed the form on your website to begin streamlining your patient onboarding process.