Creating a Patient Information Form with Acrobat 9

Example Patient Information FormIn my last article, Patient Information Forms: Making Patients Happy, I discussed my frustration with the entire paper-based Patient Information Form Process.

The frustration is fresh on my mind since I ran into the same problem today trying to schedule an appointment for my son today. My son is in school at California State University and I have to fill in forms for him here in Illinois. The receptionist couldn’t even fax me the forms since " . . . the pages are dark and they don’t fax well."


In this introductory article you’ll learn how to:

  • Create a form
  • Add or edit fields
  • Add buttons so that patients can email the form to you
  • Save the form and enable it for your patients who use the free Adobe Reader software

Acrobat Forms Basics

Using Acrobat 9, you can create a form that is fillable for your patients who are using an earlier version of the free Adobe Reader. Adobe has distributed almost a billion copies of the free Adobe Reader, so it is very unlikely that your patient won’t be able to fill out the document.

Architecturally, the form fields "live" in a layer on top of the base document.

The basic steps to create a form are:

  1. Find your form
    • If the form is on paper, scan it in. You can do that directly in Acrobat
    • Locate your existing Word, Excel, etc. form file
  2. Use Acrobat to auto-recognize form fields on the document
  3. Add, delete fields as necessary
  4. Test the form

To make it easy to try this yourself, I’ve you can download the "flat" and completed forms below.

Before Form – No fields (14K PDF)
Form with Fillable Fields, Reader Enabled (193K PDF)

Note: This article is first step for offices who wish to migrate from paper/faxed forms to electronic form. In future articles, I’ll try to cover deeper form topics.


Read on to learn how to do it yourself!

Acrobat Auto-Form Field Recognition

Acrobat includes a Wizard that makes the forms authoring process easy. Acrobat can automatically find boxes or underlines which have associated labels.

Here are a couple of examples:

Picture of table to convert to PDF Form

Create your First PDF Form

  1. On the Acrobat toolbar, click the Forms button and choose Start Forms Wizard . . .
    Starting the Form Wizard in Acrobat 9.
  2. You’ll be presented with some choices:

    Three options for converting a form in Acrobat
    A) Use this choice if you already have a PDF or a Word doc to convert
    B) Use this choice if you have a scanner attached to your computer
    C) I only recommend this choice for
    expert users who want to create a form from scratch

    For this article, I will presume you will use option A above.

  3. Click the Next button.
  4. Locate the file you wish to convert by using the Browse button to find your file, then click the Next button.
    (You can use the sample patient_information_form.pdf you downloaded above.

    Use the Browse button to find your form.
  5. Acrobat will find the fields on your form and open the window below. Click the OK button.
    Wizard Complete window
  6. Your form will appear in the Acrobat window in Editing View.
    — A Fields panel on the left lists all of the form fields which were found.
    — On the right, you can see your form with all the fields on top
    The PDF form with the fields on top.

Switching Modes
After field recognition is complete, Acrobat goes into Form Edit Mode. To exit, click the Close Form Editing button in the upper right.

To resume editing a form, click the Forms button and choose Add or Edit Fields


What next? Time to add or fix fields

Acrobat doesn’t always do a perfect job finding form fields.

  • Acrobat may find too many fields
  • Acrobat may not find all your fields
  • Acrobat might add the wrong type of field
  • Acrobat might make a field too big or too small

Deleting and Sizing Fields

  • To delete a field, simply select it and hit the DELETE key.
  • To make a field larger, simply drag one of the "handles" to the desired size.


Adding new Fields to the Form

Acrobat allows you stamp several kinds of fields on top of the form as needed.

Here are the types you will use most often are:

  • Text Fields
    Allow your patient to type whatever they want into the field
    Picture of text fields

  • Check Boxes
    Allow the patient to tick off an item
    Picture of checkbox fields in Acrobat

  • Radio Buttons
    Allow the patient to select only one out of a series of options

  • Regular Buttons
    Allow the patient to clear fields or submit a form via email.

    Picture of an Email Submit Button

You can add additional fields by clicking the Add New Field button at the top of the window
Click the Add New Field buttonAdd Field Options

Acrobat offers several types of form fields. Select the type you want from the list and stamp it on to the document.

Changing the Text Fields

Text fields in Acrobat can hold thousands of characters of text. By default, if the text doesn’t fit the field, Acrobat makes it smaller until it is eight points high. After that, Acrobat can (optionally) scroll the text in the field.

If you double-click on a Text field, you can change various options for it:

  1. Font, size, color of the text
  2. Allow or disallow multiple lines of text
  3. Limit the amount of text in a cell
  4. Formatting (e.g. make all phone number conform to a style like (888) 999-0000 even if the patient didn’t type it in that way

Text field options

Adding or Changing Radio Buttons

Radio buttons offer a mutually exclusive set of choices to your form. By using a radio button, you can ensure that the patient only chooses one out of an allowable set of options. For example, you can be either married or single, but not both.

O the sample form, Acrobat did not create fields for minor, single, married, at the top of the form. I’ve marked them with the red lines below.

Adding radio buttons is a bit trickier because Acrobat maintains them as a group.

Here’s how to add a set of radio buttons:

  1. Click the Add New Field button and chose Radio Button from the list
    Add Field Options
  2. Stamp a Radio Button on top of the document
    Stamp a Radio button on the document
  3. A yellow options window appears:

    Radio button options
    A) Fill in the name of the group of buttons
    B) Fill in the name of the button that is being clicked
    C) Click the Add another button to group and then add the next radio button

Adding an Email Button

HIPAA rules state that doctors and healthcare organizations need to be extremely careful when transmitting patient data.

Fortunately, patients are not covered entities and can choose to convey information to you the way in which they are comfortable, including email.

Here’s how to add an email button:

  1. Click the Add New Field button and chose Button from the list
  2. Stamp the button onto the form (usually in the upper right)
  3. Give the button in name in the yellow options window, then click the Show All Properties link
  4. Click the Appearance tab in the Button Properties Window
    Change the fill and border colors to your taste
    Appearance Tab of Button Properties
  5. Click the Options tab of the Button Properties window
    Fill in the Label field with the text you want to appear on the button face

    Options tab for an Acrobat button
  6. Click the Actions tab of the Button Properties window
    A) Choose Submit a form from the Trigger pop-up menu
    B) Click the Add button
    Button Actions
  7. Make the following changes . . .
    A) Enter mailto: followed by the email address you wish to receive the form
    B) Click PDF The complete document
    C) Click the OK button

    Setting the trigger
  8. Click the Close button

Reader-enabling the Form

Normally, a patient using the free Adobe Reader software can view, print and navigate a document, but cannot save any changes. This limitation includes saving data patients have typed into the form.

However, if you have Acrobat 9 (Standard or Pro), you have PDF superpowers. You can "bless" a PDF for your patients so that they can save their information in the form.

This process is called Reader-enabling the document.

Here’s how:

  1. Open the form you wish to Reader-enable

  2. Next choose the appropriate option based on which version of Acrobat you have:

    Acrobat 9 Pro:   Advanced> Extend Features in Adobe Reader . . .
    Acrobat 9 Standard: Advanced> Extend Forms Fill-in & Save in Adobe Reader . . .

  3. Acrobat will prompt you to save the form.

Tip: I recommend adding an underscore and RE to filename. That way, you can look at the filename and know if it has been Reader-enabled.

e.g. patient_form_RE.pdf

The Reader-enabled form may be emailed to patients or posted on your website. The email button is "wired" to always send the form back to you.

Licensing Limitations

The licensing agreement for Acrobat limits the number of times each individual form may be returned to you to 500 responses.

Note that this is a licensing limitation. Acrobat doesn’t actually count responses.

Five-hundred responses should be plenty to cover the needs of smaller practices. Since this is a per form limit, you could change the form which would allow for a reset of the limitation.

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