Patient Registration Forms

A patient registration form is a document that carries detailed information about the person who wants to register himself for medical attention. In some cases, the detailed medical reports of the patient are needed to attach to the document.

Why needed the form?

Booking appointments with good doctors can be hard at times. With increasing patients and decreasing number of doctors, the schedule of doctors has become very hectic.

With changing technologies, diseases are also becoming rare and difficult to diagnose. Patient registration forms are a common practice to use and book an appointment with a doctor. These registration forms contain information such as your date of birth, gender, address, and insurance policy if any.

The registration form will include the patient history, any symptoms, and medical records. This information provided by the patient is kept very confidential and is directly provided to the relevant doctor.

Once the information is compiled, the patient can also be advised if he needs to bring supportive medical documents with them. This form helps to determine the expense to be paid for the medical services.

The staff enters all the data against the payer’s account to see what benefits they are eligible for and the claim they can make from the insurance company.

The registration forms are available in the hospitals and can be hand filled. These forms are also available online from where they can be downloaded and sent back once filled.

Who can issue the form?

A hospital, medical service provider, or registered nurse/physician who can provide medical services to a person can issue this form to collect the necessary information.

For medical office…

The medical office, which acts as the administrative staff, needs this registration form to create a new account for a patient. With the improvement in the medical field, it has secured its place everywhere. Even hospitals use software for managing their data.

Patient registration form in the hospital management system

A hospital can have as much data for each patient, doctor, nurse, and medicine. Due to this bulk of data, hospitals use HMS or hospital management systems.

This software manages all the spheres of medical practice. The HMS has sections for medical forms and newly registered patients. Out of all the features, the HMS has a specialized billing feature, that will calculate the bill at the end of the consultancy by the patient.

Insurance companies also have access to this software, where they can check the details and further process the insurance claims. This data is saved in the software and can be used for later reference.

As an annual physical checkup…

The patient registration forms can be used for regular checkups as well as specialized consultancy. The data maintained can be used for an annual physical checkup as well. Routine checkups are more based on the history of the patient and how well the patient copes with any disease.

Document as MS Word…

The form is prepared using MS Word software. However, a PDF format of the document can also be made easily. The difference between these two formats is that the latter cannot be edited. Only the allowed space for each category can be filled.

The template

A medical registration form template includes the following details:



Marital status


Contact details

Employer details

Pharmacy details

Emergency contacts

Physician information/details

Primary/secondary insurance details

Acknowledgment and signatures


Patient registration form

Format: MS Word [.docx]

Simi Karton

Dr. Simi Karton currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health-related information with a straightforward approach.

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