Appointment Request Form Template
Let patients book appointments online with a simple form that captures appointment preferences, reasons for visit, and availability. Reduce phone calls and no-shows.
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Natural Language
AI parses responses
Higher Completion
Feels like texting
No Rigid Fields
Flexible responses
What is a Appointment Request Form?
An appointment request form allows patients to request medical appointments online rather than calling your office. It captures appointment preferences, reason for visit, and scheduling constraints - reducing administrative work while improving patient convenience.
Online appointment requests improve scheduling efficiency by giving your staff clear information upfront: appointment type, reason for visit, and patient availability. This eliminates back-and-forth phone calls and reduces scheduling errors.
Modern medical practices use online booking to reduce missed appointments by up to 25%. Automated confirmation emails remind patients of their appointment details and reduce no-show rates.
Key Features
Appointment Type Selection
Dropdown menu with different visit types (new patient, follow-up, checkup, etc.)
Date & Time Preferences
Multi-select options for patient preferred appointment times and days
Reason for Visit
Text field for chief complaint or reason for appointment
Insurance Verification
Captures insurance information for verification before appointment
Special Requests
Notes field for accessibility needs, interpreter requests, or preferences
Auto-Confirmation
Sends appointment details to patient via email with calendar invite option
Why Use This Template?
Reduce No-Shows
Email confirmations and reminders reduce missed appointments by 20-25%
Improve Scheduling Efficiency
Gather appointment details upfront instead of multiple phone calls
Better Patient Experience
Patients can book at any time, not just during office hours
Fewer Scheduling Conflicts
Clear information about appointment type and duration prevents overbooking
What's Included in This Template
Full Name
textIdentifies patient in appointment schedule
Email Address
emailSends appointment confirmation and reminders
Phone Number
telAllows office to contact patient with scheduling updates
Appointment Type
selectDetermines appointment duration and provider assignment
Preferred Date(s)
selectCaptures patient scheduling preferences
Preferred Time(s)
selectIdentifies available time slots for scheduling
Reason for Visit
textareaHelps provider prepare for appointment and check for complications
Special Requests
textareaCaptures accessibility needs, language preferences, or other requirements
Perfect For
Medical Practices
Reduce phone volume and improve patient access for doctor's offices and clinics
Dental Practices
Allow patients to book cleanings, exams, and procedures online
Specialty Clinics
Cardiology, dermatology, and other specialists managing high appointment volumes
Physical Therapy Centers
Allow patients to request PT sessions and indicate injury types
Frequently Asked Questions
How do I integrate this with my scheduling software?
Pro users can connect via webhooks to calendar systems (Google Calendar, Outlook) or medical scheduling software (Acuity Scheduling, SimplePractice, etc.). Alternatively, export appointments as CSV for manual entry into your system.
Should appointment requests require login?
No - keep it public so patients don't need accounts. Existing patients can still request appointments without authentication. This maximizes accessibility and reduces friction.
How do I prevent overbooking?
Don't auto-accept appointments through the form. Your staff reviews requests and confirms available slots via email. Or use conditional logic to show only available time slots (mark some as full).
Can I send appointment reminders automatically?
Formbot doesn't have built-in SMS yet, but Pro users can set up webhooks to send SMS reminders via Twilio. Email reminders can be triggered manually or through your scheduling software.
What about cancellations and rescheduling?
Create a separate cancellation/reschedule form, or send confirmation emails with a "reply to reschedule" option. Your staff handles changes via email or phone to maintain accurate records.
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