Patient Registration Form Template

By | October 29, 2016

Patient Registration Form is a printed form that is required by every hospital to register a patient that is going to have medical service in the hospital. The registration form is only required for those who are new or will become the hospital’s patient for the first time. Besides, the registration form is also needed to make the patient easily and quickly accesses the healthcare.

Patient Registration Form Word Template

Patient Registration Form Word Template

Each hospital commonly has a few forms to fill during the registration process. The registration forms are commonly available in the website of the hospital or accessible in general forms on the internet. Every new patient or the family can download the forms, print and then fill the information required. It is important procedure before the patient can make a schedule to meet the doctor in the hospital. When all of the important paperwork ready and completed, the hospital staffs will give faster service needed by the patient.

Those who need patient registration form are the people that are going to register to become a new or first time patient in a hospital. When you newly move to certain area and don’t have registration forms in the local hospital, then you need to register yourself first before you can make appointment to meet the doctor or having other medical services in the hospital. It is also required when you need to get medical service as a new patient in another hospital in the same area.

The Information to Fill Out in the Patient Registration Form

The information that should be filled out in the patient registration form includes;
– Complete personal information of the patient including the employment information
– Insurance information
– The insured information including the ID number of insurance card and the copy
– Medical and allergy information
– Menstrual period for female
– Possible genetic diseases information
– Social information such as smoking habit, alcohol and drug consumption, exercise, activities, etc.

How to Use Patient Registration Form Template

Similar with other templates, this template below can be downloaded for free and being used as reference to create your own official patient registration form. It should be useful not only for hospital, but also for any clinics or any doctors who treat their patients at their own offices. To use it, all you have to do either creating a new one or start modifying the template to meet your own requirement.

  Patient Registration Form Template (19.6 KiB, 115 hits)


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