Initial visit patient forms
Get detailed information about your patient's medical history using this simple and convenient form. You can edit, supplement and modify existing fields, set up appointment dates and times.
Available in the tariff:
Gold
Free test period of 7 days
No link to the FormDesigner website
Yes
Forms
∞
Upload storage
2 GB
Pages per form
25
Fields per form
30
Submissions
5000
Form Designer
Yes
Anti-spam protection
Yes
Adding custom CSS
Yes
What to do with this template
– Create your web form from this template
– Edit, create and delete the desired elements of this web form
– Customize the design theme of your web form
– Publish on the site and receive submissions
– Analyze results and increase income
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Our benefits
Suitable for any site
Our forms work on any site and do not depend on the platform on which it is made
More than 30 different elements
To create forms of any complexity
Logical rules and branching
Show only the required fields and pages of the form, depending on customer responses
Rules for redirections
Redirect the user to different pages, depending on their responses, after submitting the form
Online payment module
Accept online payment from customers after submitting a form
Appearance
Customize different form themes to match your website design
Saving UTM tags
Automatic saving of all UTM tags on the form page is supported
Auto-complete data from a URL or cookie
Pass additional customer data to the form via a URL or cookie
Personalized and reactive forms
Address the customer by his name in the form, using substitution macros
Print page
Redirect the user to the page to print with the specified template, with the ability to save the result in PDF
Autosave data in the form
When you visit the site again, the required fields in the form will be automatically filled in
Don't lose data from blank forms
Allows you to save data even if the client did not press the "Send" button
Order turnkey form development
No time to figure out all the settings yourself? No problem!