Request for Medical Records Form widget template

A pre-configured coding-free request for medical records form template for your site. Start using it by just inserting the code.

A Medical Records Request Form is a form that is used to request copies of medical records from a doctor, clinic, or any medical institution. Our request for medical records form template will serve to help patients make a fast request right from your website. The form is free and embedded by copy-pasting the code.

  • Create description for each element, it will be shown under the label
  • Each field can be made required for filling with asterisk (*) symbol to indicate this
  • Set custom width of the form in Default and Boxed layouts

How to add Request for Medical Records template on my site?

To introduce our widget, you don’ need coding knowledge or great skills in working with your website website builder

  • Get registered in Elfsight service through the demo in order to have a ready template;
  • Save the unique code, which can be found in your page of Elfsight Apps;
  • Insert the code to a selected page or into the site template;
  • Apply the changes. Ready!

Any moment when you want to change your form, you are welcome to do so in your account at Elfsight Apps. You don’t have to to change the website code.

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