Accessible and inclusive patient forms
Improving patient experience through accessible document design
Mountain West Dermatology asked me to review their new patient paperwork — a packet that patients consistently found difficult and unpleasant to complete. Because document accessibility is a discipline distinct from web accessibility, I approached this project as a separate design challenge. The clinic did not have the means to use HIPAA-compliant software to collect forms electronically, so PDFs remained the necessary format. My evaluation uncovered issues not only with readability and usability but also with inclusivity and relevance.
Project overview
Redesign of Mountain West Dermatology’s patient intake forms into accessible, interactive PDFs.
Project duration: September 2025
The problem: Patients were asked to complete a packet of outdated, non-interactive forms that were difficult to read, repetitive, and not inclusive. The forms could not be completed digitally, creating barriers for patients with disabilities and inconveniences for all patients.
The goal: Streamline and modernize the forms while ensuring full accessibility, inclusivity, and compliance with accessibility standards (WCAG, PDF/UA) and HIPAA requirements.
My role: UX designer, accessibility consultant, and document accessibility specialist
Responsibilities:
- Audited the existing packet for usability, readability, and accessibility issues
- Researched best practices for accessible and inclusive form design (AMA, AAD, WCAG, PDF/UA)
- Rebuilt the packet as an accessible, fillable PDF with properly tagged fields and logical reading order
- Streamlined content from eight pages across six forms to a three-page, patient-friendly format
- Tested forms with screen readers and keyboard navigation for compliance and usability
Personas
Primary persona
Rhonda
Name: Rhonda
Age: 74
Location: Grand Junction, CO
Tech comfort: Moderate — uses desktop for email and browsing, smartphone mostly for calls
Background
Rhonda is a long-time patient who values straightforward, personal interactions. She uses her computer and smartphone for basic tasks but prefers paper for anything official. Because she relies on reading glasses, dense or small print can be frustrating.
Goals
- Complete paperwork clearly and without confusion
- Avoid repeating information multiple times
Frustrations
- Small fonts and crowded layouts are hard to read
- Redundant signatures and initials feel unnecessary
- Digital-only forms would feel intimidating
Quote
“I can use my computer if I need to, but I still feel more comfortable just filling things out by hand.”
Secondary personas
- Patients with disabilities: Rely on assistive technologies such as screen readers, keyboard navigation, or voice input. Could not complete the original non-interactive forms digitally, creating a major barrier to independent access.
- Tech-savvy patients: Comfortable on computers and mobile devices, they prefer filling out forms electronically for speed and convenience—even without an accessibility need. For them, non-interactive PDFs created unnecessary printing and handwriting steps.
Design implications
- Paper-friendly design was critical: larger font sizes, increased white space, and simplified instructions improved readability for older adults.
- Digital accessibility had to be preserved: forms were rebuilt as fillable PDFs with proper tagging, ensuring patients using assistive technology—or those who simply prefer faster digital entry—could both benefit.
- By balancing these needs, the forms became inclusive and usable for all patient groups.
Pain points with the original forms
Original forms:
- Very small font size, tight margins, and long line lengths made the text difficult to read.
- Redundant and unnecessary content created cognitive overload.
- Six separate forms had been merged into one packet with no consistent branding or layout.
- Patients were required to write their name, sign, and date the form up to five times, and initial in numerous places.
- Outdated fields such as marital status and social security number were still included.
- Sex and gender questions were limited and non-inclusive.
- The forms were not interactive PDFs, meaning they could not be filled out on a computer.
Effects on patients and staff
- Patients often could not finish completing the packet before being roomed, leaving staff to collect missing details during the visit.
- Key sections were frequently skipped in error, leading to incomplete or inconsistent records.
- Patients regularly voiced frustration about the length and complexity of the paperwork.
- Staff had to spend time answering repeated questions and resolving errors, which reduced efficiency.
- The lack of digital interactivity forced every patient to handwrite their responses, creating unnecessary barriers and inefficiencies across the board.
My process
At first, recreating the forms in an accessible way nearly doubled the page count. Six separate forms had been compressed into single pages by shrinking margins, reducing the font to an unreadable size, and cramming in content with almost no white space. This approach failed accessibility standards and ignored the needs of the clinic’s older patient population, many of whom relied on reading glasses. To make the text legible and properly structured, each form initially had to expand onto multiple pages.
The breakthrough came when I realized much of the packet was redundant — the same information was being collected multiple times, and many disclosures did not need to be embedded in the intake form at all. By removing outdated questions, consolidating duplicate requests, and separating disclosures into their own document, I reduced the packet from eight cramped pages to three clean, simple pages.
Key improvements
- Streamlined structure: Removed redundant questions and consolidated six separate forms into a single, cohesive three-page packet.
- Modernized language: Rewrote the section on sex and gender to align with best-practice guidance from the American Medical Association (AMA), the American Academy of Dermatology (AAD), and other organizations. By separating sex assigned at birth and gender identity, the forms now collect medically relevant data while respecting patient identity.
- Removed outdated fields: Eliminated the marital status question, which had no clinical relevance and reflected outdated assumptions. This also supported data minimization by collecting only necessary information.
- Improved usability: Increased font size, adjusted margins, and added white space for legibility, particularly for older patients.
- Accessible format: Rebuilt the forms as interactive, fillable PDFs. Patients can now enter information into the form fields on their computers before printing, reducing barriers for those with motor disabilities and improving convenience for all patients. Each field is correctly labeled, the document is tagged for screen readers, and the reading order meets PDF/UA and WCAG standards.
Outcome
Redesigned form
The redesigned forms are clearer, shorter, and more inclusive. They address the needs of the primary persona, an older adult who prefers filling out paperwork by hand, while also supporting secondary personas: patients with disabilities who rely on assistive technology and tech-savvy patients who prefer the speed of digital entry.
This balance demonstrates how accessibility and inclusive design can transform a frustrating intake process into a patient-friendly experience that also improves staff efficiency.
Click the button below to view the updated patient registration form. For the most accessible experience — especially if you use assistive technology — download the form and open in Adobe Acrobat. While most web browsers can display PDFs, they don’t always support interactive or accessibility features consistently.
Insights from designing for accessibility
Working through this project highlighted not just the patient benefits but also the state of accessibility tooling itself. From a user perspective, it was clear that document accessibility was not built into Adobe software from the ground up. Instead, it felt bolted on as an afterthought — the accessibility features often lacked usability, consistency, and intuitive design. Some of Adobe’s “helper” tools proved unusable, forcing me to rely heavily on community expertise, trial-and-error testing, and persistence.
This experience contrasts with web accessibility, where structure and semantics create a reliable foundation when used correctly. In document accessibility, that foundation is missing from the tools. The result is that accessible forms depend less on the software guiding best practices and more on practitioners who are willing to dig into standards, troubleshoot glitches, and push the tools beyond what they were designed to do. Compounding the problem is the inconsistency of how accessible PDFs are rendered in different viewing environments. For example, Apple’s Preview will sometimes generate form fields automatically where none were placed, creating confusion. Other browsers fail to handle interactive forms correctly. The most consistent experience is with Adobe Acrobat, but that is not always what patients or staff will be using. Hopefully, those who most need document accessibility already know which tools to rely on, but this inconsistency reinforces how underdeveloped the field remains. For me, this project underscored two lessons: first, that accessibility work requires persistence and structural thinking regardless of medium; and second, that there is a pressing need for software makers to embed accessibility from the ground up, following true UX principles, instead of layering it on as an afterthought.