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Free patient intake form for physiotherapy clinics in Germany

A physio clinic in Germany needs a patient intake form that asks the right questions, shows prices in EUR, uses +49 phone numbers and fits GDPR (DSGVO) and the BDSG. CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in Europe/Berlin (UTC+1, UTC+2 during daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in Germany

  1. Full name
  2. Email
  3. What brings you in and when did it start?
  4. Pain level today (0–10)
  5. Current medication
  6. GP or referring doctor (optional)
  7. Consent to assessment
  8. Phone, in the local format (for example +49 151 23456789)
  9. Date of birth, written DD.MM.YYYY in Germany
  10. Preferred language (German and English)
  11. Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (GDPR (DSGVO) and the BDSG)"

Show the price as text on the booking page, for example "35 € for a first assessment, pay by EC card (girocard) and PayPal". CalendarForm does not take payment itself, so customers pay you the way they already do in Germany.

What physiotherapy clinics usually let customers book

For physiotherapy clinics in Germany, 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.

Germany at a glance

Time zoneEurope/Berlin: UTC+1, UTC+2 during daylight saving
CurrencyEUR (€), written like 35 €
Phone format+49 151 23456789
Date formatDD.MM.YYYY
Weekstarts Monday; weekend is Saturday and Sunday (most shops close Sunday)
How customers payEC card (girocard), PayPal, SEPA transfer and cash
Languages to considerGerman and English
Privacy lawGDPR (DSGVO) and the BDSG

Privacy: what GDPR (DSGVO) and the BDSG means for this form

Nationally, GDPR (DSGVO) and the BDSG is GDPR plus Germany's Federal Data Protection Act: link your privacy notice from the form and collect only what you need.

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 Germany

Germany changes its clocks for daylight saving, so a Initial assessment at 18:00 stays at 18:00 local time all year. CalendarForm skips times that do not exist on the night the clocks go forward.

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

Set it up in four steps

  1. Sign up free, pick the closest business type, and rename the starter form to "Patient intake form".
  2. Set the time zone to Europe/Berlin and add your opening hours.
  3. Edit the questions above, add the GDPR (DSGVO) and the BDSG consent line, and attach the form to your booking page.
  4. 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 Germany?
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 EUR.
Does the form follow GDPR (DSGVO) and the BDSG?
The form collects only the questions you add and shows your consent line. Following GDPR (DSGVO) and the BDSG is still your job: ask only what you need, say why, and link your privacy notice.
Can I write the form in German?
Yes. Questions, options and the thank-you message are free text, so you can write them in German and English.

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