Ready-to-Use COVID-19 Emergency Response Forms

Written by Lindsay McGuire on April 28, 2020

Posted in Form Optimization, Formstack Updates, Healthcare

Amidst the COVID-19 pandemic, teams need to adapt to new technology quicker than ever. If your organization is looking for a way to quickly collect essential information, Formstack is here to help.

Below you’ll find five ready-to-use form templates to help your organization capture the data you need quickly, safely, and securely. Easily embed these COVID-19 emergency response forms on your website, or access them on the go with your mobile phone or tablet.

long form tipsNote: To help those on the front lines who are dealing with the massive influx of patients and requests, we’ve launched the Formstack COVID-19 Relief Program. From now until August 1, 2020, we’re offering a free Formstack Forms HIPAA plan to all qualified US-based healthcare, nonprofit, and government organizations collecting HIPAA data as it relates to the coronavirus pandemic. To learn more and apply, visit our COVID-19 Relief Program page.

COVID-19 Self-Declaration Form

Help your HR team monitor cases of coronavirus across your organization with a COVID-19 self-declaration form. This customizable form template tracks location, symptoms, and employee details to ensure your organization is covered when following the impact of COVID-19.


Suspected COVID-19 Patient Intake

Streamline the intake of suspected coronavirus patients with this COVID-19 form template. With Formstack’s drag-and-drop form builder, it only takes a few minutes to customize this form template in minutes to fit the needs of your organization. Gather patient information such as insurance details, COVID-19 specific symptoms, and emergency contacts.


General Patient Intake

Gather the patient information you need with this general patient intake template. Quickly capture emergency contacts, insurance details, referral information, and patient symptoms. Add or remove fields to customize this pre-built healthcare template to meet your organization’s needs. Start using this general patient intake form today with Formstack’s HIPAA plan.


HIPAA Medical Release Form

Need a fast, HIPAA compliant way to let patients release their medical information at your organization? This HIPAA medical release form will make it easy for patients to grant outside access to their medical records and history.


Doctor Referral Form

Quickly and easily refer patients to specialists with this doctor referral form template. This template makes it easy to send a thorough outline of your patient interactions to specialists inside or outside your network. Use Conditional Logic to customize this referral form to meet the needs of different patients.


If you’re in need of other form templates not included above, visit our templates page to access more than 300 pre-built forms. You can also see some examples of the creative ways organizations have used Formstack to bring their operations online and keep their business moving forward.

If your organization is in need of COVID-19 form templates, we highly encourage you to review our Formstack COVID-19 Relief Program and apply if your organization qualifies. Learn more about the program in this letter from Formstack’s CEO, Chris Byers.