Doctor (Medical) Appointment Form Template

Make scheduling a doctor’s appointment with your medical practice as easy as possible. This doctor appointment form template is a simple way for both new patients and current patients to submit an appointment request. Whether you are a primary care physician or another type of healthcare provider, this request form offers both convenience and efficiency.

The easy-to-use online form offers standard contact fields for patient information, such as patient’s name, date of birth and best contact phone number. Patients can also select a preferred healthcare provider and list any pertinent medical information or concerns that they are having. As the administrator, you can enable optional notifications so you never miss another appointment request!