--- title: Hyperlipidemia Screening & Statin Eligibility Assessment Form Template | Paperform description: Professional cardiovascular risk assessment form for evaluating cholesterol results, calculating statin eligibility, and documenting lifestyle modifications for hyperlipidemia management. url: "https://paperform.co/templates/hyperlipidemia-screening-statin-eligibility-assessment" type: static generatedAt: "2026-04-04T00:44:16.618Z" --- [← Back to free form templates](/templates/) ![Hyperlipidemia Screening & Statin Eligibility Assessment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/hyperlipidemia-screening-statin-eligibility-assessment.png) [Preview](https://_preview.paperform.co/ai-template/hyperlipidemia-screening-statin-eligibility-assessment) [Use this template for free](/create?ai-template=hyperlipidemia-screening-statin-eligibility-assessment) [Surveys & Questionnaires](/templates/category/surveys/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/) About this free form template Managing hyperlipidemia requires careful screening, accurate risk stratification, and coordinated care planning. This **Hyperlipidemia Screening & Statin Eligibility Assessment** template helps healthcare providers systematically evaluate patients' cardiovascular risk factors, interpret cholesterol panel results, and determine appropriate treatment pathways—all within a streamlined digital form. Built for primary care practices, cardiology clinics, preventive health programs, and telehealth providers, this template replaces scattered paper charts and manual calculations with a structured assessment that follows current clinical guidelines. The form captures essential patient demographics, medical history, lifestyle factors, and complete lipid panel results, then helps clinicians determine statin eligibility based on established risk calculators and ACC/AHA guidelines. With Paperform's conditional logic, the form adapts to each patient's profile—showing relevant follow-up questions based on previous cardiovascular events, diabetes status, or LDL cholesterol levels. Healthcare teams can embed calculations to estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk and automatically generate personalized lifestyle modification recommendations. Connect this form to your EHR system via **Stepper** (stepper.io) to automatically route high-risk patients to care coordination workflows, schedule follow-up lipid panels, trigger medication reconciliation tasks, or send patient education materials. You can also use Stepper to notify providers when screening results require immediate attention or when patients meet criteria for statin therapy initiation. Whether you're conducting population health screenings, managing chronic disease programs, or offering preventive cardiology consultations, this template provides a professional, GDPR-compliant foundation that keeps screening protocols consistent and clinical decision-making transparent across your entire care team. Built for growing businesses, trusted by bigger ones. 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