Doctor Appointment Form Template

Available on the Free Plan

Customize this doctor appointment form template in any way you want with 123FormBuilder and use it in your organization. No coding needed!

About this template

Customize template

You only need this doctor appointment form template and the details you want to collect. Just drag and drop any kind of form field—dropdowns, text, dates, formatted phone numbers, and more. No coding skills are required! Furthermore, you have full control over the colors and fonts. And you can set up emails that auto-respond to patients and notify multiple individuals in your office.

Publish template

You can make your doctor appointment form available on a website, send it by email, or post it to a Facebook or other social media site. The Publish menu in our form builder provides easy copy-paste options for online sharing. In addition, the form is mobile-responsive, so it adapts its own display for smartphones and tablets.

Collect & manage data

In addition to sending notification emails to you, this doctor’s appointment form creates a database record with every submission. From here, you can export data to Excel and CSV for use in your patient management systems or make it into printer-friendly PDFs. In addition, the dashboard offers charts and graphs that provide an overview of your patients (age, location, gender, ethnic groups, etc.). Finally, the form can integrate with a variety of services.

Optimize processes

Make life easier for your front desk with a doctor appointment form that takes visit requests 24/7. By submitting all the information online, you’re offering patients the convenience of not waiting on hold or spending time dictating their information over the phone. Furthermore, the online form reduces stress on your administrative staff, who will no longer have to juggle calls and physician schedules.

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