--- title: How to Create a Medical History Questionnaire description: This article will guide you through the process of creating a medical history questionnaire/patient intake form. --- [Skip to content](https://support.pabau.com/en/pabau2/how-to-create-an-intake-form-medical-history#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Clients](https://support.pabau.com/en/pabau2/clients?hsLang=en) 3. [EMR - Forms](https://support.pabau.com/en/pabau2/clients?hsLang=en#emr-forms) # How to Create a Medical History Questionnaire ## This article will guide you through the process of creating a medical history questionnaire/patient intake form. **Table of Contents:** [1. How to Create a Medical History Questionnaire/Intake Form](https://support.pabau.com/en/pabau2/how-to-create-an-intake-form-medical-history#How-to-create) [2. What to Include in a Medical History Questionnaire/Intake Form](https://support.pabau.com/en/pabau2/how-to-create-an-intake-form-medical-history#what-to-include-in-a-medical-history-questionnaire) --- ### **How to Create a Medical History Questionnaire/Intake Form** #### **Step 1: Navigate to Medical Forms** Start by [logging into your Pabau account](https://app.pabau.com/). Once you're in, locate the [Setup](https://app.pabau.com/setup) section at your screen's left bottom corner. Within the Setup menu, click on [Forms](https://app.pabau.com/setup/medical-forms) under Clinical. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-02-45-5012-AM.png?width=670&height=396&name=image-png-May-18-2026-10-02-45-5012-AM.png) #### **Step 2: Create a Medical Form** Click on the **"Create Form"** button at the top right corner to get started.  ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-16-32-5703-AM.png?width=670&height=171&name=image-png-May-18-2026-10-16-32-5703-AM.png) You can choose to [use AI to create your form template](https://support.pabau.com/en/pabau2/how-to-generate-a-smart-form-using-ai?hsLang=en), use any other pre-created templates or start from scratch with a blank template. In this case, select the first option which is **"Blank Template."** ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-17-20-2750-AM.png?width=487&height=468&name=image-png-May-18-2026-10-17-20-2750-AM.png) #### **Step 3: Complete General Tab Details** Proceed to choose the appropriate form type from the following options. In this case, select **"Intake Form."** ![How to Create a Medical History Questionnaire\_1](https://support.pabau.com/hs-fs/hubfs/Clients%20category/How%20to%20Create%20a%20Medical%20History%20Questionnaire_1.png?width=213&height=395&name=How%20to%20Create%20a%20Medical%20History%20Questionnaire_1.png) In the **General** menu on the left, you can assign a name to the form and select which services it should apply to. If you set this as your default form, you don't need to select any services — it will automatically be sent to clients when they book any service. The **"Request to be completed prior to appointment"** toggle will also be enabled automatically and cannot be changed when a form is set as default. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-24-23-9035-AM.png?width=195&height=425&name=image-png-May-18-2026-10-24-23-9035-AM.png) #### Step 4: Complete Components Tab Click to expand the **Components** tab to customize the form's appearance using various components, such as text fields, multiple or single-choice questions, and dropdown menus, depending on your needs. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-38-43-8657-AM.png?width=222&height=554&name=image-png-May-18-2026-10-38-43-8657-AM.png) You can add components to your template by using the drag and drop feature. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-53-50-7282-AM.png?width=551&height=308&name=image-png-May-18-2026-10-53-50-7282-AM.png) Then, proceed to compose the questions or the text by clicking the pen icon that appears when hovering over the components on the far right side. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-56-50-6065-AM.png?width=530&height=226&name=image-png-May-18-2026-10-56-50-6065-AM.png) After adding the text, click the **"Save component"** button to finalize. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-58-44-6222-AM.png?width=307&height=244&name=image-png-May-18-2026-10-58-44-6222-AM.png) #### Step 5: Show Advanced Settings Proceed to [configure the advanced settings](https://support.pabau.com/en/pabau2/how-to-configure-advanced-settings-in-medical-form-templates?hsLang=en) in the component of the medical form templates if needed. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-59-51-6672-AM.png?width=304&height=239&name=image-png-May-18-2026-10-59-51-6672-AM.png) You will see three options available under Advanced Settings: #### Input Type Select the format that matches the type of information you want to collect in this field: ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-11-32-29-8245-AM.png?width=289&height=66&name=image-png-May-18-2026-11-32-29-8245-AM.png) | Input Type | Use For | | --- | --- | | **Text** | General written answers, names, notes | | **Email** | Email address format | | **Number** | Numerical values only | | **Date** | Date picker input | | **Phone** | Phone number format | | **URL** | Website links | #### Linked Field The **Linked field** setting connects this component to an existing field in the client's record. When a linked field is set, the answer submitted in the form will automatically populate the corresponding field in Pabau — saving your team from manually transferring information. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-11-32-11-9266-AM.png?width=303&height=97&name=image-png-May-18-2026-11-32-11-9266-AM.png) Click the **Select Field** dropdown, choose the relevant field from the list, and click **+ Add** if you need to link to more than one field. #### Default Value The **Default value** setting pre-fills the field with a value when the form loads. You can use merge tags here to pull in dynamic data automatically — for example, entering **\[APPOINTMENTNAME\]** will populate the field with the name of the linked appointment. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-11-33-20-1015-AM.png?width=296&height=109&name=image-png-May-18-2026-11-33-20-1015-AM.png) **NOTE:** Using merge tags in the Default value field reduces the amount of information clients need to fill in manually. #### Step 7: Save Your Changes Once you have finished configuring the component, click **Save component** to apply your changes. ![image-png-May-18-2026-10-58-44-6222-AM](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-10-58-44-6222-AM.png?width=337&height=268&name=image-png-May-18-2026-10-58-44-6222-AM.png) When all components are set up, click **Save Form** in the top right corner to save the full form template. ![](https://support.pabau.com/hs-fs/hubfs/image-png-May-18-2026-11-28-46-3497-AM.png?width=320&height=59&name=image-png-May-18-2026-11-28-46-3497-AM.png) By following these steps, you can easily create an intake form/medical form questionnaire in Pabau. **NOTE:** We suggest checking out our [Medical Forms](https://support.pabau.com/en/pabau2/medical-forms?hsLang=en) article for more information on medical forms.  --- ### What to Include in a Medical History Questionnaire A medical history questionnaire typically collects personal details, health background, and consent information. Below are the recommended fields to include: #### Personal Information - First name - Last name - Date of birth - Gender - Address - Phone number - Email address - Emergency contact name and number #### Medical History - Current medications - Known allergies (medication, food, environmental) - Existing medical conditions (e.g. diabetes, heart conditions, skin conditions) - Previous surgeries or procedures - Family medical history (where relevant) #### Lifestyle - Smoking status - Alcohol consumption - Pregnancy or breastfeeding status #### Treatment-Specific Questions - Areas of concern or reason for visit - Previous aesthetic or medical treatments - Any reactions or complications from past treatments #### Consent & Declaration - Confirmation that the information provided is accurate - Consent to treatment - GDPR / data processing consent **NOTE:** Not all fields will be relevant to every clinic. You can customize the form to include only the sections that apply to your treatments and services.  --- Was this guide helpful? Let us know by voting below - your feedback helps us write clearer articles. For [more guides](https://support.pabau.com/en/pabau2?hsLang=en), browse the related articles below or use the search bar at the top of the page. 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