FREE 8+ Sample Patient Registration Forms in PDF | MS Word

A patient registration form has to be filled up whenever a patient comes to a hospital or clinic to receive medical treatment. It’s also often known as the patient admission form, which collects information about the patient’s name, age, marital status, gender, medical history, previous consultation and other important information. The data is used for record keeping an administrative use. If the patient requires any prompt medical attention during an emergency, the form can be filled up by any relative, friend, or guardian. You May also See Medical Consultation Form

New Patient Registration Form

A new patient registration form has to be filled up when a person, who was not previously treated in that hospital. Patients have to provide exhaustive details about their condition, including the name of the doctor treating now, whether they are from abroad, or from the armed forces. A special new patient registration form has to be filled if a child is admitted to a hospital.

Dental Patient Registration Form

As the name implies, a dental patient registration form has to be filled up, especially before a dental surgery or a critical dental examination. Information required to be filled up include dental insurance details, place of work, details about last checkup and dentist who attended. Information on whether the patient has any other medical condition like rheumatic fever, angina/chest pain, blood pressure, is also recorded.

Medical Patient Registration Form

A medical patient registration form is usually required when a patient has to appear for a medical checkup or is about to be hospitalised. The details to be entered include insurance information, previous medical history, whether the patient smokes or drinks, whether the patient had any surgery or invasive procedures. Sometimes, ethnicity and cultural background are also recorded

Patient Access Registration Form

A patient access registration form contains the name, address, gender, age and similar other details of a patient. Emergency contact information, primary and secondary information, name of the primary care physician, medicines taken, prior medical history, allergies to which a patient may be prone to, name of the guarantor, or spouse, whether employed or retired, are all entered in this form.

Patient Registration Form in Hospital

Content

Standard Patient Registration Form

Patient Registration Form Pediatrics

New Patient Registration Form Template

International Patient Registration Form

Use and Purpose of Patient Registration Form

During a surgery, patient registration reveals data that is further used to carry medical treatment. The patient registration form is a legally enforceable document which is useful during healthcare expenses claims settlement. For a hospital or healthcare center, the patient registration form is the first step towards revenue generation. Can be used for reference if the patient revisits in the future. Is usually updated on a daily basis as long as the patient is undergoing treatment in the hospital. You May also See Medical Consent Forms

Benefits of a Patient Registration Form

A patient registration form keeps vital information regarding prescribed medicines and insurance claims. People usually forget their dose of medicine and the patient registration can be used to keep a check on dosages. Helps to keep a record of all surgeries or medications administered so attending doctors can easily check them. A patient registration form helps to determine whether the patient is responding to treatment, in the light of his/her present conditions.You May also See Medical Claim Forms

It’s very important that a hospital or healthcare provider keeps all patient information updated so that the best healthcare can be extended to the person. Their families can also be communicated in case of emergencies. At every appointment check, the patient party may be asked to verify the insurance and contact information.

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