Sports Medicine Intake Form
Intake

Sports Medicine Intake Form

3 pages13 fieldsHIPAA-ready
Ready to useHIPAA compliantCustomize in minutes

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Sports Medicine Intake Form

Sports Medicine Intake Form

Page 1 of 3

Athlete Information
Phone Number
(555) 867-5309
Email Address
jane.martinez@email.com
Sport & Position
Competition Level
Select an option...
Current Injury/Complaint
Enter details here...
Mechanism of Injury
Select an option...
Previous Sports Injuries
Enter details here...
Concussion History
Diabetes
Hypertension
Heart disease
Asthma
Training Regimen
Enter details here...
Pain Level (0-10)
None (0)
Mild (1-3)
Moderate (4-6)
Severe (7-10)
Return-to-Play Goals
Enter details here...
Consent to Treatment
Sign here
Submit
Use this template

Sign up and start customizing in minutes.

The Sports Medicine Intake Form is tailored for sports medicine physicians, athletic trainers, and performance medicine clinics. It goes beyond standard orthopedic intake to capture athletic-specific information: sport and position played, training regimen and volume, competition level, previous sports injuries with return-to-play timelines, and concussion history.

The concussion history section uses a structured approach to document previous head injuries, symptoms experienced, and recovery timelines. This information is critical for managing current head injury presentations and determining return-to-play protocols. The injury assessment section captures mechanism of injury with sport-specific contexts (contact, non-contact, overuse).

Performance goals and return-to-play expectations are documented collaboratively with the athlete, establishing clear benchmarks for rehabilitation progress. The form also captures nutritional habits, supplement use, and sleep patterns -- factors that significantly influence injury recovery and prevention. This template serves both the treatment and prevention sides of sports medicine.

What's included

  • Athletic history and competition level
  • Sport-specific injury assessment
  • Concussion history documentation
  • Training regimen and volume tracking
  • Return-to-play goals and timelines
  • Nutritional and lifestyle assessment
  • E-signature capture

Who uses this template

  • Sports medicine physicians and clinics
  • Athletic training facilities
  • College and professional team medical staff
  • Performance and rehabilitation centers

All form fields

13 fields across 3 pages. Customize any field after signing up.

Athlete InformationText
Phone NumberPhone
Email AddressEmail
Sport & PositionText
Competition LevelDropdown
Current Injury/ComplaintLong Text
Mechanism of InjuryDropdown
Previous Sports InjuriesLong Text
Concussion HistoryCheckbox
Training RegimenLong Text
Pain Level (0-10)Multiple Choice
Return-to-Play GoalsLong Text
Consent to TreatmentE-Signature

How to use the Sports Medicine Intake Form

Getting started with this template takes just a few minutes. Sign up for a free Formisoft trial, then select the Sports Medicine Intake Form from the template library. The form is ready to use immediately, but you can customize every field, add your practice logo, and adjust the layout to match your workflow.

Setup steps

  1. 1Choose the template. Find the Sports Medicine Intake Form in the template library and click “Use this template” to add it to your account.
  2. 2Customize fields. Add, remove, or reorder any of the 13 fields. Set fields as required or optional based on your practice needs.
  3. 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
  4. 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
  5. 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.

Frequently asked questions

Is the Sports Medicine Intake Form HIPAA compliant?

Yes. All Formisoft templates, including the Sports Medicine Intake Form, are HIPAA compliant. Data is encrypted with 256-bit AES at rest and TLS 1.3 in transit. A Business Associate Agreement (BAA) is included on every plan.

Can I customize the fields in this template?

Absolutely. You can add, remove, reorder, or modify any of the 13 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

How do patients fill out this form?

Patients receive a link via SMS, email, or QR code. They complete the form on their phone, tablet, or computer before their appointment. No app download required.

Can I send this form automatically before appointments?

Yes. Formisoft's workflow automation can send intake forms automatically when an appointment is booked. You can set the timing (e.g., 48 hours before the visit) and include reminders for patients who haven't completed it.

Does this template work on mobile devices?

Yes. The Sports Medicine Intake Form is fully responsive and works on any device. Most patients complete intake forms on their phone, so every template is optimized for mobile-first use.

8 min saved per patient98% patient satisfaction3x faster than paper

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