Health and Lifestyle Templates - Patient Medical History Form

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Use This Template

This medical info online form enables you to capture medical and patient information.  Add or remove any fields as you need.  You can also easily push the data into any other 3rd party system you have in place. You can also post a QR code for this form to facilitate on-site data capture. This template is fully customizable using FormTitan form builder and easily integrated with Salesforce to have your data synced in real time.

TypeOther
Desktop
Tablet
Mobile
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installation for Google Site

Please follow these simple steps

  • Click on the Edit Page button on your page in Google Site
  • Click on Insert Menu
  • Click on More Gadgets link. Now the Setup your gadget form appears
  • Click on Add gadget by URL link.
  • Copy the following URL and paste it in the Enter URL box https://formtitan.com/google/gadgets/.xml
  • Click on Add button
  • Provide Gadget Settings
    • Your Email address
    • Size of form
    • Theme
  • See the Preveiw of the gadget
  • Click on OK button