Doctor Appointment Form Template
Free up your phone lines with online scheduling using this doctor appointment form template that you can customize and use with the help of our form builder. With 123FormBuilder, you’ll be able to manage medical appointments online and you can safeguard your form with HIPAA-compliance that we provide upon request. Contact us for more information.

Customize template
All you need is this doctor appointment form template and a list of 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 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 to a Facebook or other social media site. The publish menu in our form builder provides easy copy-paste options for web page embeds, popup lightboxes, and direct social sharing. In addition, the form is responsive-designed, which is just a fancy way of saying that it is optimized to adjust 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. There the information can be exported to Excel and CSV for use in your patient management systems or made 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.