Shorter waiting-room time
Patients complete intake at home, so appointments start on schedule.
Form Types
Create a patient registration form for your clinic
Filling forms in the waiting room slows every appointment down. Sending a patient registration form ahead of time gives the clinician the history, allergies and insurance details before the patient arrives, and gives reception a clean record instead of handwriting.
How to create a patient registration form in Formblyt
Decide what happens before the visit
Contact details, medical history, current medication, allergies, insurance and consent are the usual pre-visit set.
Generate and tidy the form
Describe your intake to the AI generator, then rename and reorder questions in the builder to match your clinic's flow.
Use conditional history questions
Only ask about pregnancy, smoking or specific conditions when previous answers make them relevant.
Add consent with a signature
Include a treatment or data-processing consent statement with an e-signature field.
Send with the appointment reminder
Include the short link in the confirmation SMS or email, or put a QR code at reception for walk-ins.
Review before the appointment
Open the submission in the dashboard before the patient is called in.
What to include in a patient registration form
These are the fields most clinics, dental practices, physiotherapists and independent practitioners end up needing. Start with them, then cut anything you will not act on — shorter forms get finished.
- Patient name, date of birth and gender
- Phone number and email
- Address and emergency contact
- Reason for visit / presenting symptoms
- Current medication
- Known allergies
- Past medical and surgical history
- Insurance provider and policy number
- GP or referring doctor
- Consent statement with signature
Not sure where to start? Describe your patient registration form to the AI form generator and edit the draft it produces.
Benefits
Legible, structured history
No handwriting to decipher and no missing fields on the allergy section.
Consent on record
The signed consent statement is stored with the intake, timestamped.
Ready for the clinician
The clinician reads a clean summary instead of a scanned page.
Features
Conditional medical history
Reveal follow-up questions only when a condition is reported.
E-signature consent
Capture treatment and privacy consent inside the same submission.
Insurance and document uploads
Let patients photograph their insurance card or referral letter.
Private by default
Only your account can read submissions, and you can export or delete them at any time.
Frequently asked questions
Can patients complete this on a phone?
Yes. The published form is mobile-first and patients can photograph documents directly with the phone camera.
Can I capture consent signatures?
Yes. Add an e-signature field beneath the consent statement; the signature is saved as part of the submission record.
Who can see patient submissions?
Only your Formblyt account. Responses are protected by row-level access rules, and you control exports and deletion. Check your local healthcare data rules before collecting clinical information online.
Is the patient registration form free to use?
Yes. You can build and publish a patient registration form on the Formblyt free plan, within the free plan's monthly form and response limits. Paid plans raise those limits and unlock branding removal and advanced analytics.
Do respondents need an account?
No. Anyone with the link or QR code can complete the form in a browser. You can optionally require an email address if you need to identify each respondent.
Build your patient registration form now
Start from a prompt or a template, edit the questions, and publish a shareable link in minutes. Built for clinics, dental practices, physiotherapists and independent practitioners.