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 New York?

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 USD.

Does the form follow state privacy laws (no single federal law)?

The form collects only the questions you add and shows your consent line. Following state privacy laws (no single federal law) 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 Spanish.

Free forms › United States › New York

Free patient intake form for physiotherapy clinics in New York

A physio clinic in New York, New York needs a patient intake form that asks the right questions, shows prices in USD, uses +1 phone numbers and fits state privacy laws (no single federal law). CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in America/New York (UTC−5, UTC−4 during daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in New York

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 +1 (212) 555-0123 or a New York landline like +1 (212) 555-0147
Date of birth, written MM/DD/YYYY in the US
Preferred language (English and Spanish)
Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (the New York SHIELD Act and state privacy laws (no single federal law))"

Show the price as text on the booking page, for example "$40 for a first assessment, pay by card and Apple Pay". CalendarForm does not take payment itself, so customers pay you the way they already do in the US.

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 New York, 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.

New York at a glance

Time zone	America/New York: UTC−5, UTC−4 during daylight saving
Currency	USD ($), written like $40
Phone format	mobile +1 (212) 555-0123; New York landline +1 (212) 555-0147
Date format	MM/DD/YYYY
Week	starts Sunday; weekend is Saturday and Sunday
How customers pay	card, Apple Pay, Venmo and Zelle
Languages to consider	English and Spanish
Privacy law	the New York SHIELD Act, plus state privacy laws (no single federal law)

Privacy: what the New York SHIELD Act means for this form

In New York, New York requires reasonable security for private information and notice if it leaks.

Nationally, state privacy laws (no single federal law) is there is no one national privacy law; several states, such as California, have their own, so keep the form short and explain why you ask each question.

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. Health providers covered by HIPAA have extra rules for patient information; a general booking form is not a HIPAA compliance tool.

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 New York

New York 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 America/New York, 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 America/New_York and add your opening hours.
Edit the questions above, add the the New York SHIELD Act and state privacy laws (no single federal law) 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 New York?: 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 USD.
Does the form follow state privacy laws (no single federal law)?: The form collects only the questions you add and shows your consent line. Following state privacy laws (no single federal law) 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 Spanish.