Patient Intake Form
About this template
A patient intake form on A4 laid out as nineteen tables, including a current medications table by name, dosage, frequency and purpose.
Tags
What is in this template
Read from the source files of this template.
- Document class
article[11pt, a4paper]- Compiles with
- pdfLaTeX
- Pages in the compiled PDF
- 2
- Bibliography
- None
- Files
- 2 files: 1 .tex, 1 image
- Packages
inputencfontenchelvetgeometryxcoloramsmathamssymbtabularxbooktabstikztcolorboxfancyhdrenumitemhyperreffontawesome5
\documentclass[11pt,a4paper]{article}
\usepackage[utf8]{inputenc}
\usepackage[T1]{fontenc}
\usepackage[scaled]{helvet}
\renewcommand\familydefault{\sfdefault}
\usepackage{geometry}
\geometry{
a4paper,
top=0.8in,
bottom=0.8in,
left=0.8in,
right=0.8in,
headheight=20pt,
footskip=30pt
}
\usepackage[table]{xcolor}
\usepackage{amsmath,amssymb}
\usepackage{tabularx}
\usepackage{booktabs}
\usepackage{tikz}
\usetikzlibrary{positioning, calc, shapes.geometric, backgrounds, patterns}
\usepackage[many]{tcolorbox}
\usepackage{fancyhdr}
\usepackage{enumitem}
\usepackage{hyperref}
\usepackage{fontawesome5}
\definecolor{primary}{HTML}{0D5C75}
\definecolor{secondary}{HTML}{19B5FE}
\definecolor{neutraldark}{HTML}{2B2D42}
\definecolor{bglight}{HTML}{F4F7F6}
\linespread{1.15}
\setlength{\parindent}{0pt}
\newcommand{\checkbox}{\tikz[baseline=-0.3ex]\draw[line width=0.6pt, color=primary] (0,0) rectangle (0.22cm,0.22cm);}
\newcommand{\checkedbox}{\tikz[baseline=-0.3ex]{
\draw[line width=0.6pt, color=primary] (0,0) rectangle (0.22cm,0.22cm);
\draw[line width=0.8pt, color=primary] (0.04cm,0.11cm) -- (0.09cm,0.05cm) -- (0.19cm,0.18cm);
}}Put this template on your own page
Paste this badge on a thesis guide, a course page or a README. One click opens the template as a new project in the reader's own LetX account.
[](https://letx.app/open?template=patient-intake-form)<a href="https://letx.app/open?template=patient-intake-form"><img src="https://letx.app/badges/open-in-letx.svg" alt="Open in LetX"></a>Frequently asked questions
What does the Patient Intake Form template load?
It uses the article class (options: 11pt, a4paper), builds with pdfLaTeX, and loads 15 packages, including inputenc, fontenc, helvet, geometry, xcolor, amsmath, amssymb and tabularx.
How long is the Patient Intake Form sample?
The compiled sample is 2 pages, from 2 files: 1 .tex, 1 image. Replace the sample text with yours and the layout stays.
Is the Patient Intake Form template free to use online?
Yes. "Open as Template" makes it your own LetX project: edit the LaTeX in the browser, invite collaborators to edit with you in real time, and download the compiled PDF. There is nothing to install.
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