Healthcare
Clinic Appointment Request
Request a clinic visit with one question at a time.
Why use this template
A wellness site can look calm and still send visitors to a cluttered form. This consultation request keeps the same calm pace: which conversation they want, when they can meet, and whether that meeting is in the studio or online. Customize the service list, publish the form, and answer from one pipeline instead of a shared inbox.
Part of Formgrid’s healthcare form templates workflow for organised enquiries and lead capture.
- Service, date, time, and visit format
- In person and virtual choices on one screen
- Opening image and a short thank you
- Easy to reword for a studio, spa, or consult practice
What this template collects
- Consultation type
- Preferred date and time of day
- In person or virtual
- Name, email, and phone
- Confirmation that clinical notes are left out
Who this template is for
Wellness centers, studios, and consult practices booking intro conversations.
Formgrid features included
- One question on each screen, with a welcome page and a thank you page
- Email notification when a request arrives
- Lead pipeline with New, Contacted, and Converted
- Spam protection on every submission
- Shareable link, or embed the form on your website
- Free to customize. No code required
How it works
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1
Open the live preview and walk through the questions.
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2
Choose Customize Free and edit the wording, colors, and fields.
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3
Publish a link or embed the form on your clinic website.
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4
Each submission lands in Formgrid so your team can follow up.
Live preview
Click through the form, then customize the questions for your own copy.
Frequently asked questions
Can I list my own services?
Yes. Replace the consultation choices with the services you offer.
Does it support virtual consultations?
Yes. The form asks whether the visit should be in person or online.
Is there a free plan?
Yes. You can customize and publish on the free plan, with no credit card required.