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Creative ICR Inc
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Medical History Forms

EzData provides a fast and easy way to create medical forms for tracking patient history, allergies, medications and more. With dozens of different field types you can capture almost anything you need. This includes Social Security numbers, names, street addresses and more.

For tracking information like allergies, weight-loss, alcohol consumption, smoking, and exercise use the optical mark recognition or checkbox fields. In addition you can provide generic text fields for the user to write choices not available in the optical mark recognition boxes. Multiline text boxes are supported so users can right as much detail as required.

If your office uses bar codes on patient forms you can include the bar code field in your form to make tracking patients easier. The barcode field in EzData is an image capture field. So you can place barcode stickers in the area provided or you could include the barcode as part of the form by loading it as a bitmap image and placing it over the barcode field.

Many medical history forms oftenc require a customer signature. EzData provides a simple way to capture any image including customer signatures. In addition to customer signatures you could also capture drawings or other images relating to the patients illness or reason for visit. For example many orthopedic offices have an outline picture of a person that the patient uses to color in the areas they are having problems with.

Additional customization of forms can be done by adding images, text, boxes and other fields to create a professional looking form that is automatically processable. Using the Twain scanner interface EzData makes form processing easy and straightforward and it works with standard hardware available at any office supply or computer store.

Medical History Image

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