Patient Registration Form


What is a Patient Registration Form?

A patient registration form is required to be filled out by patients who visit a healthcare facility for the first time. This information is entered and stored in the EHR/EMR of the healthcare facility for easy access and updation. It typically includes basic information about the patient, such as their name, contact information, details of emergency contact, and insurance details. 

Why is a Patient Registration Form needed? 

A patient registration form is an important document to record the information of the patient’s visit. It helps the healthcare provider get basic patient information, the symptoms they are facing, their expectations from the treatment, and their medical history. 

Here are the top reasons why medical facilities need patient registration forms: 

  • To acquire a comprehensive information about the patient 
  • To verify insurance details of the patient 
  • To facilitate a seamless billing procedure 
  • To acquire the patient’s consent 
  • To avoid any miscommunication between provider and patient

All these details help the provider in diagnosing the problem effectively and designing the most appropriate treatment plan.

What details are included in a Patient Registration Form?

A patient registration form typically includes the following particulars to be filled by the patient:

  • Name, contact details, address
  • Insurance details
  • Social security number 
  • Details of emergency contact 
  • Purpose of visit 
  • Over-the-counter medications 
  • Health goals 
  • Medical history
  • Consent of the patient 

What things should a medical facility keep in mind while creating and dealing with patient registration forms?

Here are some of the best practices that healthcare providers need to follow while creating and dealing with new patient registration forms:

  • Ensure that the questions in the form are direct and simple in nature 
  • Ensure that the information is accurate and the form is complete 
  • Maintain confidentiality of information by storing the information securely in the EMR
  • Ensure HIPAA-compliance

How to Use this Downloadable Patient Registration Form?

Share in advance
This form can be sent over to the patients as soon as they book an appointment at your healthcare practice, capturing this information in advance can help you not only prepare for the appointment but also ask for any follow-up information that might be necessary

Make it easy to access and update
Your patient registration form will receive a lot more responses if its easy to update and access for your patients, sending the form as a link via SMS alongside the appointment confirmation text has resulted in a 90% response rate for our customers.

Send Reminders
If the patient does not respond to the form, timely reminders should be sent highlighting the reasons and also the benefits of filling out the patient registration form.

Customize the Form
Consider customizing the form based on your learnings and other necessaary information you would like to capture given your marketing and operation practices and particular problems you might want to solve at your practice. For eg – If patient engagement is a concern asking for the patients preferred mode of communication might be a good idea.

Why should you Digitize your Patient Registration Forms?

Allows for EMR/EHR Integrations
Digital forms can be directly integrated with your EHR/EMR/PMS to allow easy access of information at any time

Ensure zero errors
With digital forms you can ensure zero errors in capturing the necessary patient information

Allows you to track metrics
Using Digital forms you can easily track metrics and better access how your healthcare facility is performing For eg – If you had 60 patient registrations last month you would ideally want this number to grow by 5-10% every month

Allows you to run personalized patient recall campaigns
Data on your patients and specifically the problem they came in to address can help you run personalized patient recall campaigns to improve patient retention For eg- If a patient ccame in for a scaling appointment at your dental practice you can run a campaign inviting them back 12 months down the line.