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Doctor Appointment Form Template

Doctor Appointment Form Template

✓ No credit card required
✓ No time limit on Free plan

Need to see a doctor? What's your first name? And your last name? Okay {{field:01F7979EBBPK01D51D2JJ7GA9R}}. Is this going to be your first visit, or are you already a patient of ours? Can you briefly describe the reason you're booking an appointment? What day works best for you, {{field:01F7979EBBPK01D51D2JJ7GA9R}}? We'll send you an email address to confirm your appointment. Where to? Please leave your phone number in case we need to call you about last-minute changes to your appointment. Thanks {{field:01F7979EBBPK01D51D2JJ7GA9R}}. We'll see you on {{field:c6d578e2-d1aa-4841-9665-7fd6f5a5ec93}}. Thanks for completing this typeform Now *create your own* — it's free, easy, & beautiful

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Just what the doctor ordered for stress-free scheduling

Keep things running smoothly around the doctor’s office, all thanks to a typeform. This template shows you how easy it can be for your patients to book an appointment. Meanwhile, integrations behind it take care of things like automatic scheduling.

Doctor appointment form FAQs:

They can book an appointment in a matter of seconds. This doctor appointment form works on any device, so patients can even fill it out on the go.

It’s easy to use, showing only one question at a time on the screen. Patients can briefly indicate the reason for their visit, pick a date that fits them, then wait for you to send their appointment time via email—all without having to call up or wait on hold.

Our integrations help you automate a lot of the busywork around scheduling. Hook this doctor appointment form up with apps like Arrangr and watch how booking, reserving and cancelling is all managed automatically.

It goes beyond administration, though. If you ask patients to describe their issues in the form, your doctors know beforehand what they’re dealing with. That way, everyone comes to the table well-prepared.

Before you send out your form, there are two things you should do:

Set up a BAA (Business Associate Agreement) with us

Typeform is a HIPAA-compliant company, so all the healthcare-related info you process with us is legally airtight. But for you to be 100% HIPAA compliant, you’ll first need to set up a BAA. Do this by filling out this typeform, or contacting your Typeform account manager.

Check the local data collection laws

Data collection laws aren’t a one-size-fits-all thing—especially when there’s sensitive medical info involved. So before hitting share, seek advice from a local lawyer to make sure you’ve covered everything.