diff --git a/src/pages/form/search.vue b/src/pages/form/search.vue
new file mode 100644
index 0000000..6c2ef93
--- /dev/null
+++ b/src/pages/form/search.vue
@@ -0,0 +1,64 @@
+<template>
+	<view class="h-full relative px-24rpx bg-#fff">
+		<view class="fixed top-0 left-0 right-0 px-24rpx bg-#fff">
+			<u-search
+				v-model="searchVal"
+				@change="$u.debounce(handleChange, 1000)"
+				@search="$u.debounce(handleChange, 300)"
+				shape="square"
+				margin="20rpx 0rpx 30rpx 0rpx"
+				height="80rpx"
+				searchIconSize="48rpx"
+				:showAction="false"
+				:searchIcon="$assets('/sou.png')"
+				placeholderColor="#666"
+				placeholder="搜索您需要陪诊的医院"
+				clearabled
+				focus
+			/>
+		</view>
+		<view class="pt-130rpx pb-80rpx">
+			<view
+				v-for="item in dataList"
+				:key="item.id"
+				class="flex items-center justify-between px-30rpx py-20rpx text-#000 border-border-black border-b border-solid"
+				@click="
+					$Router.push({
+						path: '/form',
+						query: { hospitaId: item.id, hospitaName: item.name }
+					})
+				"
+			>
+				<view class="">
+					{{ item.name }}
+				</view>
+				<view
+					class="text-white bg-#FF8CA6 rounded-24rpx px-30rpx py-10rpx text-center hover:shadow-md"
+				>
+					选择
+				</view>
+			</view>
+		</view>
+	</view>
+</template>
+<script setup>
+const instance = getCurrentInstance()
+const { $api } = instance.proxy
+const searchVal = ref('')
+const dataList = ref([])
+
+const handleChange = async () => {
+	const { list = [] } = await $api.fetchPzHospitalList({
+		name: searchVal.value.trim()
+	})
+	dataList.value = list
+}
+</script>
+
+<style lang="scss" scoped>
+:deep {
+	.u-search__content {
+		border-radius: 16rpx !important;
+	}
+}
+</style>