RCTECH Medical Forms

Making the patient intake process simple, easy, secure and extremely cost effective!

We deliver the forms through a secure hosted application which can be easily added to to any website. If you don't see the form which you are looking for, simply let us know and we can create a custom form for you instantly. Our current standard medical forms include:

New Patients

Existing Patients

  • Doctor Visit / Appointment Request
  • Referral Request
  • Patient Registration (English, Spanish & Russsian version available)
  • Medical History - OBGYN, Adult, Child
  • Contact Us
  • Workers Comp
  • Patients Satisfaction Survey
  • SNOT 20
  • Prescription Refill
  • PT/OT Renewal - Ortho
  • Image/Film Request - Radiology
  • P/E Request Form - Pediatrics
  • Urinary Incontinence Form
  • Breast Evaluation Questionnaire

Medical History Forms

Partnering with Primetime Medical Software, RCTECH offers Instant Medical History forms and other unique clinical questionnaires that integrate with many leading EMR vendors. These mobile compatible forms allow practices and hospitals to administer medical history and other clinical questionnaires securely through their current website.

How does it work?


Patient answers questions according to their visit.

Branching technology mimics what a clinician would ask.

Data is organized into a visit note, saved in the EMR.

Monthly revenue can increase substantially per physician.



Our Medical History Forms include:

  • History of Present Illness
  • Review of Systems
  • Past Medical, Family & Social History
  • Risk Assessments & Care Protocols

Why Choose RCTECH Forms?

  • Reduces Office Visits substantially. Reports show that 60% of the visit note is completed by the patient and documented in clinical terminology before the exam. This saves practices several thousand dollars in under-coding and dictation costs per physician, per month.
  • Improves EMR Quality. More clinically relevant data is collected and documented with better accuracy than with conventional histories. EMR data shows accuracy rates of 94-97% since patients provide a final review before answers are submitted.
  • Increases Patient Satisfaction. Patients spend less time waiting and more time with shared decision making - the single metric that contributes most to patient satisfaction. Medical histories are completed online, at their own pace while branching technology enables patients to move through the interview quickly.

Other Online Forms Available and provided by RCTECH

Secure On-line Bill Pay

Allow patients to pay their account balance conveniently and securely through your own website. We have different options available to support your needs. 

Secure On-line Radiology Exam Requisition Form

Radiology groups - allow your referring physicians to securely log-in and request an exam through your website. We have a standard online request form that can be customized to your requirements.