Electronically Signed Simple Medical History For Free

Upload your document
Select documents
Up to 100 MB for PDF and up to 25 MB for DOC, DOCX, RTF, PPT, PPTX, JPEG, PNG, or TXT
Note: Integration described on this webpage may temporarily not be available.
0
Forms filled
0
Forms signed
0
Forms sent
Function illustration
Upload your document to the PDF editor
Function illustration
Type anywhere or sign your form
Function illustration
Print, email, fax, or export
Function illustration
Try it right now! Edit pdf

Users trust to manage documents on pdfFiller platform

Send documents for eSignature with signNow

Create role-based eSignature workflows without leaving your pdfFiller account — no need to install additional software. Edit your PDF and collect legally-binding signatures anytime and anywhere with signNow’s fully-integrated eSignature solution.
How to send a PDF for signature
How to send a PDF for signature
01
Choose a document in your pdfFiller account and click signNow.
Screenshot 1
How to send a PDF for signature
02
Add as many signers as you need and enter their email addresses. Move the toggle Set a signing order to enable or disable sending your document in a specific order.
Note: you can change the default signer name (e.g. Signer 1) by clicking on it.
Screenshot 2
How to send a PDF for signature
03
Click Assign fields to open your document in the pdfFiller editor, add fillable fields, and assign them to each signer.
Note: to switch between recipients click Select recipients.
Click SAVE > DONE to proceed with your signature invite settings.
Screenshot 3
How to send a PDF for signature
04
Select Invite settings to add CC recipients and set up the completion settings.
Click Send invite to send your document or Save invite to save it for future use.
Screenshot 4
How to send a PDF for signature
05
Check the status of your document in the In/Out Box tab. Here you can also use the buttons on the right to manage the document you’ve sent.
Screenshot 5
All-in-one PDF software
A single pill for all your PDF headaches. Edit, fill out, eSign, and share – on any device.

Watch a short video walkthrough on how to add an Electronically Signed Simple Medical History

pdfFiller scores top ratings in multiple categories on G2

Add a legally-binding Electronically Signed Simple Medical History in minutes

pdfFiller enables you to handle Electronically Signed Simple Medical History like a pro. No matter what system or device you use our solution on, you'll enjoy an user-friendly and stress-free method of executing documents.

The whole signing process is carefully protected: from importing a file to storing it.

Here's the best way to create Electronically Signed Simple Medical History with pdfFiller:

Select any readily available way to add a PDF file for completion.

Screenshot

Utilize the toolbar at the top of the page and select the Sign option.

Screenshot

You can mouse-draw your signature, type it or add a photo of it - our tool will digitize it in a blink of an eye. Once your signature is set up, click Save and sign.

Screenshot

Click on the form area where you want to add an Electronically Signed Simple Medical History. You can drag the newly created signature anywhere on the page you want or change its settings. Click OK to save the adjustments.

Screenshot

As soon as your form is ready to go, hit the DONE button in the top right corner.

Screenshot

As soon as you're done with signing, you will be taken back to the Dashboard.

Use the Dashboard settings to get the executed form, send it for further review, or print it out.

Still using different programs to create and modify your documents? Use our solution instead. Use our tool to make the process fast and simple. Create forms, contracts, make template sand more useful features, without leaving your account. You can use Electronically Signed Simple Medical History right away, all features are available instantly. Have an advantage over other tools. The key is flexibility, usability and customer satisfaction.

How to edit a PDF document using the pdfFiller editor:

01
Upload your form using pdfFiller
02
Choose the Electronically Signed Simple Medical History feature in the editor's menu
03
Make all the needed edits to your document
04
Click the orange “Done" button to the top right corner
05
Rename the document if needed
06
Print, save or share the file to your device

How to Send a PDF for eSignature

What our customers say about pdfFiller

See for yourself by reading reviews on the most popular resources:
Fritz
2016-03-07
Fan Bloody Tastic on my CHROMEBOOK, nearly real time and it would be 5 stars. Realtime not yet available in this part of Australia. PERFECT fit for 100% cloud and paperless. Love it, just re thinking it and it is now totally 5 stars. Thanks :)
5
Greg Barnes, President 2wisted Ventures I
2018-06-28
PDF Filler is one of the most used applications in my toolkit. I am a business owner and I am almost every day finding myself using PDF Filler. I would definitely be interested in learning more ways I can use it!!!
5
Desktop Apps
Get a powerful PDF editor for your Mac or Windows PC
Install the desktop app to quickly edit PDFs, create fillable forms, and securely store your documents in the cloud.
Mobile Apps
Edit and manage PDFs from anywhere using your iOS or Android device
Install our mobile app and edit PDFs using an award-winning toolkit wherever you go.
Extension
Get a PDF editor in your Google Chrome browser
Install the pdfFiller extension for Google Chrome to fill out and edit PDFs straight from search results.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.
Zoom is a HIPAA compliant web and video conferencing platform that is suitable for use in healthcare, provided a HIPAA-covered entity enters into a business associate agreement with Zoom prior to using the platform.
A: No. The HIPAA Privacy Rule does not require you to notarize authorization forms or have a witness. Though taking the time to fill out an authorization form and get a patient's signature is an extra step, it's an important one that you can't afford to overlook.
After that, the regulation generally requires that you retain any signed Acknowledgement for at least six years after the patient is no longer active in your practice.
PHI stands for Protected Health Information and is any information in a medical record that can be used to identify an individual, and that was created, used, or disclosed in the course of providing a health care service, such as a diagnosis or treatment.
Health care providers will ask patients to sign a form saying that they received a copy of the notice of privacy practices. The law does not require patients to sign this. If a patient refuses to sign, it does not prevent a health care provider from using or disclosing information in ways already permitted under HIPAA.
The Final Rule modifies and expands the statements that covered entities must include in the Notice of Privacy Practices, the HIPAA-mandated notice that apprises patients of their rights with regard to protected health information (PHI) and the limits imposed upon a covered entity's uses and disclosures of PHI.
These requirements include paper and electronic medical records. The following are various examples of acceptable signatures. Handwritten signatures certify the knowledge or acceptance of the information documented. The handwritten signature must be present in the document and must be legible.
Suggested clip How to design your own amazing signature — YouTubeYouTubeStart of suggested clipEnd of suggested clip How to design your own amazing signature — YouTube
A document that's legally binding can be upheld in court. Any agreement that two parties make can be legally enforced, whether it's written or verbal. Their signature is proof of their acceptance of the contract. The signature binds both parties to the terms.
A signature log is a typed listing of provider names followed by a handwritten signature. A signature log can be used to establish signature legibility as needed throughout the medical record documentation. MR encourages providers to include their professional credentials/titles as well on the signature log.
Can doctors working in the same practice sign orders for each other? One doctor has ordered, but another signs the order. CMS Transmittal 327 CR 6698, states physicians cannot sign for the other physicians.
It must be placed between forward slashes; The person signing must insert his or her own signature; and. The name of the person signing must be printed or typed immediately adjacent to the S-signature, and be reasonably specific, so the identity of the signer can be readily recognized.
eSignature workflows made easy
Sign, send for signature, and track documents in real-time with signNow.