Transgender Hormone Therapy Intake Form
Intake

Transgender Hormone Therapy Intake Form

1 page•9 fields
Editable templateCustomize in minutes

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formisoft.com/f/transgender-hormone-therapy-intake
Transgender Hormone Therapy Intake Form

Transgender Hormone Therapy Intake Form

Page 1 of 1

Legal Name
Jane Martinez
Chosen Name
Jane Martinez
Pronouns
Enter details here...
Date of Birth
03/15/1985
Gender Identity
Select gender...
Hormone Therapy Goals
Enter details here...
Previous Gender-Affirming Treatments
Enter details here...
Mental Health Support
Enter details here...
Current Medications
Submit
Use this template

Sign up and start customizing in minutes.

Start with the Transgender Hormone Therapy Intake Form template and tailor it to your practice. It includes 9 editable fields across 1 page. Included questions: Legal Name, Chosen Name, Pronouns, Date of Birth. The full field list below shows what you will get when you add this template to your account.

Choose this template to open an editable form. Review the questions, keep only the information your practice needs, and add your branding. Preview the patient experience before sharing a link or embedding the form. Responses can be reviewed in Formisoft and exported as a PDF.

What's included

  • Legal Name
  • Chosen Name
  • Pronouns
  • Date of Birth
  • Gender Identity
  • Hormone Therapy Goals
  • Previous Gender-Affirming Treatments
  • Mental Health Support
  • Current Medications

Who uses this template

  • Gender-affirming care clinics
  • Endocrinology practices
  • LGBTQ health centers
  • Primary care providers
  • Transgender health specialists

All form fields

9 fields across 1 page. Customize any field after signing up.

Legal NameText
Chosen NameText
PronounsLong Text
Date of BirthDate
Gender IdentityDropdown
Hormone Therapy GoalsLong Text
Previous Gender-Affirming TreatmentsLong Text
Mental Health SupportLong Text
Current MedicationsMedications

How to use the Transgender Hormone Therapy Intake Form

Getting started with this template takes just a few minutes. Sign up for a Formisoft trial, then select the Transgender Hormone Therapy Intake Form from the template library. Review the included questions, customize your fields, and preview the form before sharing it.

Setup steps

  1. 1Choose the template. Find the Transgender Hormone Therapy 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 9 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

How does Formisoft protect responses?

Formisoft provides secure form collection and a Business Associate Agreement (BAA). Your practice must review the form content, access permissions, and sharing workflow for its requirements.

Can I customize the fields in this template?

Absolutely. You can add, remove, reorder, or modify any of the 9 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?

With a plan that includes automation, you can configure workflows to send forms and reminders. Appointment-based sending requires the booking event to reach Formisoft.

Does this template work on mobile devices?

Yes. The Transgender Hormone Therapy 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.

Start with this template

Sign up and start customizing the Transgender Hormone Therapy Intake Form for your practice. Set up in minutes.

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