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 Japan?

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 JPY.

Does the form follow the APPI?

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

Can I write the form in Japanese?

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

Free forms › Japan

Free patient intake form for physiotherapy clinics in Japan

A physio clinic in Japan needs a patient intake form that asks the right questions, shows prices in JPY, uses +81 phone numbers and fits the APPI. CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in Asia/Tokyo (UTC+9 all year, no daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in Japan

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, in the local format (for example +81 90-1234-5678)
Date of birth, written YYYY/MM/DD in Japan
Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (the APPI)"

Show the price as text on the booking page, for example "¥3,000 for a first assessment, pay by card and PayPay". CalendarForm does not take payment itself, so customers pay you the way they already do in Japan.

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 Japan, 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.

Japan at a glance

Time zone	Asia/Tokyo: UTC+9 all year, no daylight saving
Currency	JPY (¥), written like ¥3,000
Phone format	+81 90-1234-5678
Date format	YYYY/MM/DD
Week	starts Sunday; weekend is Saturday and Sunday
How customers pay	card, PayPay, IC cards and konbini payment
Languages to consider	Japanese
Privacy law	the APPI

Privacy: what the APPI means for this form

Nationally, the APPI is the Act on the Protection of Personal Information: state the purpose of use and keep to it.

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 Japan

Japan has no daylight saving, so your timetable never shifts against UTC: UTC+9 every day of the year.

Customers booking from abroad still see the time in Asia/Tokyo, 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/Tokyo and add your opening hours.
Edit the questions above, add the the APPI 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 Japan?: 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 JPY.
Does the form follow the APPI?: The form collects only the questions you add and shows your consent line. Following the APPI is still your job: ask only what you need, say why, and link your privacy notice.
Can I write the form in Japanese?: Yes. Questions, options and the thank-you message are free text, so you can write them in Japanese.