Patient Registration Form Template

If you're looking to simplify your patient registration experience, look no further. We've designed an elegant solution for new clients to sign up for your clinic. You can make this template your very own form by clicking the ”Use this Template” button.

We've designed this template for a placeholder dentistry practice, but you can easily customise it to match your business. Simply head over to the “Theme” to change the look and feel of your form, from the colours to the fonts to perfectly match your branding. It's important to ensure your form matches your logo and business to incentivise respondents to fill it out completely.

Once the form is submitted, you can optionally show your responders a "Thank you" screen to let them know the form has been successfully submitted. You can even customise the page layout, images and colours to make your new patients feel welcome.