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 Cebu City?

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 PHP.

Does the form follow the Data Privacy Act of 2012?

The form collects only the questions you add and shows your consent line. Following the Data Privacy Act of 2012 is still your job: ask only what you need, say why, and link your privacy notice.

Can I write the form in Cebuano?

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

Free forms › Philippines › Cebu City

Free patient intake form for physiotherapy clinics in Cebu City

A physio clinic in Cebu City needs a patient intake form that asks the right questions, shows prices in PHP, uses +63 phone numbers and fits the Data Privacy Act of 2012. CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in Asia/Manila (UTC+8 all year, no daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in Cebu City

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 +63 917 123 4567 or a Cebu City landline like +63 32 xxx xxxx
Date of birth, written MM/DD/YYYY in the Philippines
Preferred language (Cebuano, English and Filipino)
Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (the Data Privacy Act of 2012)"

Show the price as text on the booking page, for example "₱500 for a first assessment, pay by GCash and Maya". CalendarForm does not take payment itself, so customers pay you the way they already do in the Philippines.

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 Cebu City, 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.

Cebu City at a glance

Time zone	Asia/Manila: UTC+8 all year, no daylight saving
Currency	PHP (₱), written like ₱500
Phone format	mobile +63 917 123 4567; Cebu City landline +63 32 xxx xxxx
Date format	MM/DD/YYYY
Week	starts Sunday; weekend is Saturday and Sunday
How customers pay	GCash, Maya, bank transfer and card
Languages to consider	Cebuano, English and Filipino
Privacy law	the Data Privacy Act of 2012

Privacy: what the Data Privacy Act of 2012 means for this form

Nationally, the Data Privacy Act of 2012 is Republic Act 10173: tell people what you collect and why, and get consent before you use it for anything else.

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 Cebu City

Cebu City has no daylight saving, so your timetable never shifts against UTC: UTC+8 every day of the year.

Customers booking from abroad still see the time in Asia/Manila, 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 Asia/Manila and add your opening hours.
Edit the questions above, add the the Data Privacy Act of 2012 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 Cebu City?: 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 PHP.
Does the form follow the Data Privacy Act of 2012?: The form collects only the questions you add and shows your consent line. Following the Data Privacy Act of 2012 is still your job: ask only what you need, say why, and link your privacy notice.
Can I write the form in Cebuano?: Yes. Questions, options and the thank-you message are free text, so you can write them in Cebuano and English.