Patient Forms & Printable Templates
Everything below is designed to be filled or printed — from the pre-visit intake form that skips the reception wait, to the wallet medical card that speeds up emergency care.
Patient Intake Form
The same form you'd fill at reception — complete it before you arrive to skip the wait.
Personal Medical Summary (Wallet Card)
One-page template: conditions, medications, allergies, blood type, emergency contacts — carry printed.
Insurance Claim Checklist
Step-by-step checklist of the documents your insurer needs — tick off as you collect them.
Trek Medical Kit Packing List
Printable checklist for your trekking first aid kit — Rx, OTC, wound care, documents.
Nepali Allergy Card
Bilingual Devanagari card listing common allergens + emergency phrases for restaurants.
First Aid Field Guide
Printable 6-skill reference: blisters, sprains, wounds, dehydration, altitude, hypothermia.
Altitude Symptom Diary
Daily log template for headaches, SpO2, and Lake Louise scoring during your trek.
Need a Specific Form?
Insurers, employers, and trekking agencies sometimes need specific forms (claim supplements, fitness certificates, vaccination records). Email info@thamelclinic.org with the form attached — we can usually complete it during your visit.
The Forms That Speed Up Care
The administrative layer of a medical visit — registration, history, insurance details — takes time at the desk that the online forms take at home. Each form here moves that work earlier: intake before arrival, records requests without the phone call, feedback that reaches us directly. The form filled at home is the queue skipped at the clinic.
Available forms
- Patient intake — pre-registration before your visit
- Medical summary — request your records for home doctors or insurers
- Feedback — tell us what worked or what needs fixing
- Contact — general inquiries and questions
Optional but Recommended
None of these forms are mandatory — every function they serve can happen at the clinic. They exist for efficiency: the patient who pre-registers walks in to a file that already exists, rather than starting from a blank form. For urgent care, skip the forms entirely and come in.
The Form Value
Patient form — the free (the printable that saves the visit time). For the preparation, the downloaded that is completed.
The Visit Efficiency
Pre-completed form — the saved time (the efficient that reduces the wait). For the appointment, the prepared that is faster.
The Free Form
Clinic form — the free (the intake/consent that is provided). For the visit, the completed-ahead that is the efficient.
The Efficiency Value
Pre-visit form — the time-saved (the ~5-10 minutes that is the consult-focus). For the prepared, the done that is the smooth.
What forms are available?
Patient intake (pre-registration before arrival), medical summary request (your records for home doctors or insurers), feedback, and contact forms. Each serves a specific purpose in the patient workflow — the forms exist to make the visit efficient.
Should I fill forms before my visit?
If you have an appointment or know you are coming — yes. The intake form pre-registers you; the medical summary form requests records. For walk-ins, the same forms are completed at reception; the online version just does it ahead of time.
Is form data confidential?
Yes — form submissions become part of your patient record and are treated with medical confidentiality. The data is transmitted securely and accessible only to clinical staff for your care.
What if I make a mistake on a form?
Contact us to correct it — errors in medical history or contact details should be corrected promptly since they affect your care. At the visit, review the information with the clinician; corrections are made on the spot.
Do I need to print forms?
No — submit online and we have it. For your own records you may print or save confirmations, but we do not require printed copies. The digital submission is sufficient.
