Document Template

Automated Medical History Form template for healthcare providers.

Detailed medical history is the foundation of good care — but paper history forms take 20 minutes and arrive illegible. Docuplete's conditional interview shows follow-up questions only when triggered: a patient who denies cardiovascular history skips the next ten questions.

Live demo · No account needed

See Docuplete fill a healthcare form in 60 seconds.

Open the sandbox, answer a few questions, and watch the PDF auto-fill. No sign-up, no credit card required.

Open live sandbox

June 15th launch

Drop your email to secure early access when we open to new teams. One email on launch day.

What gets automated

Every field — mapped and filled automatically.

Upload your existing medical history form PDF. Common fields for healthcare providers include:

Patient name, date of birth, genderChief complaint and current symptomsPast medical diagnoses (with conditional follow-ups)Surgical historyCurrent medications and dosagesKnown allergies (with reaction type)Family medical history (conditional)Social history: smoking, alcohol, exercisePatient signature and date
Works with your existing PDF. Docuplete doesn't require a special template format. Upload the form you already use.

How it works

Set up once. Send a link every time.

1

Upload your PDF

Upload the medical history form you already use — any standard PDF. No reformatting or special software needed.

2

Map the fields

Open the PDF in Docuplete's visual mapper. Drag answer boxes onto each field exactly where it appears on the form.

3

Send one link

Generate a unique link for each client. They complete a guided interview on any device — no account required.

4

Receive the completed form

On submission the filled PDF is generated, stored, saved to Google Drive, and synced to HubSpot — automatically.

Why it matters

Stop preparing each medical history form by hand.

No manual data entry

Client answers map directly into the PDF. No re-keying, no copy-pasting, no transcription errors.

E-sign with OTP verification

Clients sign in the same session. Identity verified via email OTP — creating a legally defensible audit trail.

RFC 3161 trusted timestamp

Every signed document receives a trusted timestamp — tamper-proof proof of when it was signed, on every plan.

Google Drive auto-save

Completed PDFs are automatically saved to your Drive folder after every submission.

HubSpot sync

Submission data syncs to HubSpot contacts automatically — find or create the record and attach the completed PDF.

Full audit trail

Every submission records who signed, when, from which device — stored alongside the document.

Send your first medical history form in under 10 minutes.

14-day free trial. No credit card. Works with PDFs you already have.

Start free trial

Starts at $69/mo.

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