Family Medical History Form

Asks about cancer history (by type), cardiovascular disease history, and diabetes history. Built for primary care preventive health visits.

Questions
10
Page
1
Time
about 3 min

Includes

  • Conditions checklist

Your practice

Family Medical History Form

Live preview. Tap through it like a patient.

Who it is for

  • Primary care preventive health visits
  • Genetics counseling and risk assessment
  • Oncology screening programs
  • New patient comprehensive intake

Formisoft for Mental Health

What's inside

  1. Full NameText · Required
  2. Cancer History (by Type)Long Text
  3. Cardiovascular Disease HistoryLong Text
  4. Diabetes HistoryLong Text
  5. Neurological ConditionsLong Text
  6. Autoimmune DisordersLong Text
  7. Mental Health HistoryConditions
  8. Relative Details (Who/Age of Onset)Long Text
  9. Adopted/Unknown Family HistoryLong Text
  10. Date of BirthDate

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Family Medical History Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 10 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Family Medical History Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk