Medical History Form Template for Patient Intake

Streamline patient intake and improve healthcare documentation with this Medical History Form Template for PowerPoint and Google Slides, designed for clinics, hospitals, and private practices. This template provides a comprehensive structure to collect and organize critical patient health information, ensuring that medical professionals have access to accurate and up-to-date records at a glance.

The form is organized into clearly labeled sections, including Patient Information, Medical Conditions, Family Medical History, Lifestyle & Habits, and Vaccination & Immunization. It enables users to input details such as chronic illnesses, allergies, past surgeries, medications, and contact details in an easy-to-understand format. Checkboxes are included for common conditions like diabetes, hypertension, asthma, and stroke, simplifying the intake process and reducing errors.

With its clean, professional design and intuitive layout, this form enhances both digital and paper-based recordkeeping systems. The editable format allows healthcare providers to tailor the form to their practice’s specific needs—whether for pediatric care, general practitioners, or specialist consultations.

This template is fully compatible with PowerPoint and Google Slides, making it a versatile option for printing, online intake forms, or inclusion in healthcare presentations and documentation systems. The structured design ensures that important health indicators are not overlooked, supporting better diagnoses and continuity of care.