Hospital Admission Form

What Is a Hospital Admission Form?

A Hospital Admission Form is a written instrument distributed in a hospital upon the arrival of a patient to ask the individual about the symptoms or painful sensations that bother them and figure out which doctor is supposed to examine the patient based on the provided information. The purpose of this document is to let the medical facility know more about the patient that came for a scheduled appointment or was rushed to a hospital because they got an injury or became suddenly sick.

A Hospital Admission Form template can be downloaded via the link below.

Usually, a part of the form is filled out by a hospital administrator or doctor - they state the date of admission and indicate the procedure and the name of the physician in case there is a planned treatment. The patient is then asked to write down their name, address, telephone number, date of birth, marital status, and demographic information and briefly explain what brought them to the doctor. It is also crucial to notify the medical provider about the names and contact details of people that should be reached out to in the event of an emergency.

Ensure the document is signed in order to give consent to share private medical information and agree to other rules imposed by a hospital - for example, a patient that will have surgery must confirm they agree to abstain from operating machinery and drinking alcohol after getting anesthesia.

Haven't found the form you're looking for? Take a look at the related forms below:

• Against Medical Advice Form;
• Patient Intake Form;
• Acupuncture Intake Form.