Medical History Template

The Medical History Form template permits monitoring sick person records with all their private and contact information, and may optionally include their ailments, observed symptoms and medicinal drug information. The template additionally affords regions to your sufferers and informs you approximately their allergies, etc.

Design & Personalize

Use this free template and customize your Report Forms anyway you like. With MightyForms’ drag & drop editor, you can easily add, edit and delete a variety of fields. Include your logo and the colors and theme of your choosing. Any edit you make to the theme of the form is saved to your account, so you can use it on other forms. Add a personalized pop-up or confirmation e-mail to your respondents.

Publish & Integrate

Publish your Report Forms with a click of a button. Just copy and paste the code to embed it on a website, send it to an email list or share it over social media. You can integrate your Report Forms with Google Tag Manager and Google Analytics, that way you can more easily keep track of how well it is performing. You can also integrate your form with thousands of apps through Zapier.

Collect & Share

Keep track of real-time results and views of your forms right on your MightyForms account. Our templates are 100% responsive, so your respondents can fill out your Report Forms from any device. Edit existing entries and download the reports anytime. You can also customize notification emails to be sent to you and members of your team, optimizing your workflow and keeping everyone on the same page.

Icons choice & Image choice

Eye-catching design is one of the key ingredients for a successful template that works. Make your form much more visually appealing and interactive by adding customizable Image Choice and Icons Choice fields.

Explore multiple-choice fields

Flexibility is one of the most important features of a good form editor as it means freedom to adapt to different situations, and this is where we have something to offer you as well. Whereas the flexible and adaptive. MightyForms toolset allows you to apply settings to each field individually, you can include an unlimited number of multiple-choice fields on your form to enable your respondents to select more than one item at a time, and thus capture more complete and detailed data.

Opt for the single-choice option

As opposed to the multiple-choice option, single-choice fields allow the respondent to select but one answer from a list of proposed items. Setting this option for the required fields helps you collect specific information that you can analyze effectively afterwards.

Continuous Capture

Тrack each form’s performance and make adjustments anytime. Ensuring data capture as the form is being populated — no matter if it gets submitted or abandoned afterwards, — the Continuous Capture feature allows you to pinpoint the fields with the highest drop-off rate, send form data straight to your Integrations, and automatically reach out to users that that quit filling to achieve the best possible results.

Catch leaving leads with Notifications or SMS

In just a few clicks, you can set up instant SMS/email alerts on submitted or abandoned forms to keep your eye on the ball. Merely add a notification content, be it a welcome message or a reminder of unfinished fields, select a recipient by specifying your team member, sender, or your own email, and you're ready to go.

Save & Resume

Make it possible for your respondents to get back to completing the form right from the point where they left off. Just tick the Save & Resume checkbox in Edit Form view, and your users can save the generated code to resume the submission at any convenient time.

Frequently asked questions

Nope, not a single line. All you have to do is drag and drop the required elements into your workspace using the wieldy MightForms editor, populate the fields with engaging content, and throw in an image or two for good measure. That's how your beautiful form comes into being in a matter of minutes.
Sure! MightyForms offers an unlimited selection of template customization tools to accommodate any goal and taste. Once you’ve chosen a suitable option from our plentiful template catalog, you can easily modify its fonts and colors, upload custom images, rearrange elements as you see fit, and even add your company logo for a professional touch.
Absolutely! After you finish editing the template and have it published, you will be presented with generated embed code that you can easily copy and paste wherever you want your form to appear. Alternatively, you can easily share your form using the ready-made shortcode, or simply by hitting the Share button.
Yes! Being armed with the plethora of integrations supported by the MightyForms builder, you can seamlessly connect your great forms to your favorite web applications, such as Google Sheets, WordPress, or MailChimp, and transfer data with no effort at all.
As of right now, for payment forms we're using Stripe to capture sensitive information such as credit card details. MightyForms doesn't record and store credit card data on it's side.

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