Health and Lifestyle Templates - Medical Info And Emergency Form

https://d34n0xw2ofs24w.cloudfront.net/ftFP2012244.png
Use This Template

Use this form to have patients enter medical information online.  Add or remove any fields as you need.  You can 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. Edit this template and fully customize it with FormTitan form builder. We provide a bi-directional Salesforce integration that will allow your fillers to read data from your SF account and update data as well.

TypeOther
Desktop
Tablet
Mobile
5 out of 5 188

View similar templates

x
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