Is CalendarForm a medical records system?

No. It handles booking and pre-visit forms. Keep clinical notes in your records system.

Can patients reschedule?

They cancel with the link in their email and book a new time.

Is a free patient intake form enough for physiotherapy clinics in Abuja?

For most small physiotherapy clinics, yes. You get 250 form submissions and 100 bookings free every month; after that, $5 buys 2,000 more submissions or 500 bookings, and packs never expire. Prices on your page can be in NGN.

Does the form follow the Nigeria Data Protection Act 2023?

The form collects only the questions you add and shows your consent line. Following the Nigeria Data Protection Act 2023 is still your job: ask only what you need, say why, and link your privacy notice.

Can I write the form in English?

Yes. Questions, options and the thank-you message are free text, so you can write them in English and Hausa.

Free forms › Nigeria › Abuja

Free patient intake form for physiotherapy clinics in Abuja

A physio clinic in Abuja needs a patient intake form that asks the right questions, shows prices in NGN, uses +234 phone numbers and fits the Nigeria Data Protection Act 2023. CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in Africa/Lagos (UTC+1 all year, no daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in Abuja

Full name
Email
What brings you in and when did it start?
Pain level today (0–10)
Current medication
GP or referring doctor (optional)
Consent to assessment
Phone: mobile like +234 803 123 4567 or a Abuja landline like +234 9 xxx xxxx
Date of birth, written DD/MM/YYYY in Nigeria
Preferred language (English and Hausa)
Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (the Nigeria Data Protection Act 2023)"

Show the price as text on the booking page, for example "₦15,000 for a first assessment, pay by bank transfer and card". CalendarForm does not take payment itself, so customers pay you the way they already do in Nigeria.

What physiotherapy clinics usually let customers book

Initial assessment: a 1-to-1 appointment, 60 min
Follow-up: a 1-to-1 appointment, 30 min
Sports massage: a 1-to-1 appointment, 45 min

For physiotherapy clinics in Abuja, CalendarForm gives a physio, chiropractor or small wellness clinic an appointment page with separate services for first assessments and follow-ups, plus a pre-visit form so the first session starts with the history already in hand.

Make the initial assessment longer than follow-ups.

Set minimum notice so you can prepare for new patients.

Do not collect information you do not need.

Abuja at a glance

Time zone	Africa/Lagos: UTC+1 all year, no daylight saving
Currency	NGN (₦), written like ₦15,000
Phone format	mobile +234 803 123 4567; Abuja landline +234 9 xxx xxxx
Date format	DD/MM/YYYY
Week	starts Monday; weekend is Saturday and Sunday
How customers pay	bank transfer, card and USSD
Languages to consider	English and Hausa
Privacy law	the Nigeria Data Protection Act 2023

Privacy: what the Nigeria Data Protection Act 2023 means for this form

Nationally, the Nigeria Data Protection Act 2023 is Nigeria's data law: get consent, say why, and protect what you collect.

This patient intake form asks about health, which most privacy laws treat as sensitive. Ask only what the clinician really needs and say why next to the question.

CalendarForm keeps each business's answers separate, lets you export them to CSV, and does not use them for anything else. Link your own privacy notice in the form's description.

Booking times in Abuja

Abuja has no daylight saving, so your timetable never shifts against UTC: UTC+1 every day of the year.

Customers booking from abroad still see the time in Africa/Lagos, with the zone printed next to it, and their confirmation email repeats it.

Set it up in four steps

Sign up free, pick the closest business type, and rename the starter form to "Patient intake form".
Set the time zone to Africa/Lagos and add your opening hours.
Edit the questions above, add the the Nigeria Data Protection Act 2023 consent line, and attach the form to your booking page.
Share your link. Each booking sends an email confirmation with a cancel link, and a reminder 24 hours before.

Questions

Is CalendarForm a medical records system?: No. It handles booking and pre-visit forms. Keep clinical notes in your records system.
Can patients reschedule?: They cancel with the link in their email and book a new time.
Is a free patient intake form enough for physiotherapy clinics in Abuja?: For most small physiotherapy clinics, yes. You get 250 form submissions and 100 bookings free every month; after that, $5 buys 2,000 more submissions or 500 bookings, and packs never expire. Prices on your page can be in NGN.
Does the form follow the Nigeria Data Protection Act 2023?: The form collects only the questions you add and shows your consent line. Following the Nigeria Data Protection Act 2023 is still your job: ask only what you need, say why, and link your privacy notice.
Can I write the form in English?: Yes. Questions, options and the thank-you message are free text, so you can write them in English and Hausa.