COVID-19 Pre-Vaccination Checklist

Use this COVID-19 pre-vaccine checklist to safely collect patient data prior to vaccine distribution.

Simplify your workflows

Get a comprehensive view of a new patient’s health history with Formstack's digital COVID-19 pre-vaccination checklist. This form template includes fields to help you collect information such as contact details, vaccination status, eligibility, and other health information.

Build contactless workflows

Implementing contactless or curbside workflows is key to keeping patients and staff safe. Limit the number of people in your waiting room by allowing patients to complete their checklist prior to their appointment.

Automate communication

Use notification emails to follow up with patients about future vaccine appointments. Easily customize these messages for different patient populations and set up multi-week reminders to ensure they schedule and receive their second dose.

Collaborate on data

Securely share medical information and form submissions with your back office by setting up multi-step approvals. Once a form is submitted, approvers will be notified via email so they can confirm the patient’s appointment and add necessary notes.

Stay HIPAA compliant

With Formstack’s HIPAA-friendly features, you can equip your team with the tools they need to streamline healthcare workflows without risking patient privacy. Access powerful security measures such as encryption, audit logging, and user-level permissions.

Using Formstack reduces failure when bringing in new patients. It increases efficiency and cuts down on data entry for both patients and staff.
Dr. Chris Bojrab
President of Indiana Health Group

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