If you want to create and customize your form, it is easy with our user-friendly and intuitive HIPAA compliant form builder. Implement personalized branding, images, text, and more.
IMPORTANT:
You can customize the wording of these questions.
By default, we ask the following questions:
•Patient Name•Patient Email
•Patient Phone Number
•Appointment information (service, date and time preference)
More options available:
•Map Address
•Website URL
•Yes/No and Multiple-Choice Question
•File Upload
•Signature