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Free patient intake form for physiotherapy clinics in Saudi Arabia

A physio clinic in Saudi Arabia needs a patient intake form that asks the right questions, shows prices in SAR, uses +966 phone numbers and fits the Personal Data Protection Law (PDPL). CalendarForm gives you that form free for 250 submissions a month, joined to a booking page that shows times in Asia/Riyadh (UTC+3 all year, no daylight saving).

Make this form free See a demo booking page

What to put on a patient intake form in Saudi Arabia

  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 +966 50 123 4567)
  9. Date of birth, written DD/MM/YYYY in Saudi Arabia
  10. Preferred language (Arabic and English)
  11. Consent: "I agree to the physio clinic using these details for my booking, as set out in the privacy notice (the Personal Data Protection Law (PDPL))"

Show the price as text on the booking page, for example "SAR 150 for a first assessment, pay by mada and STC Pay". CalendarForm does not take payment itself, so customers pay you the way they already do in Saudi Arabia.

What physiotherapy clinics usually let customers book

For physiotherapy clinics in Saudi Arabia, 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.

Saudi Arabia at a glance

Time zoneAsia/Riyadh: UTC+3 all year, no daylight saving
CurrencySAR (SAR), written like SAR 150
Phone format+966 50 123 4567
Date formatDD/MM/YYYY (Hijri dates are also used)
Weekstarts Sunday; weekend is Friday and Saturday
How customers paymada, STC Pay, Apple Pay and card
Languages to considerArabic and English
Privacy lawthe Personal Data Protection Law (PDPL)

Privacy: what the Personal Data Protection Law (PDPL) means for this form

Nationally, the Personal Data Protection Law (PDPL) is the Saudi data law: explain why you collect each detail and keep it no longer than needed.

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 Saudi Arabia

Saudi Arabia has no daylight saving, so your timetable never shifts against UTC: UTC+3 every day of the year.

Customers booking from abroad still see the time in Asia/Riyadh, 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 Asia/Riyadh and add your opening hours.
  3. Edit the questions above, add the the Personal Data Protection Law (PDPL) 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 Saudi Arabia?
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 SAR.
Does the form follow the Personal Data Protection Law (PDPL)?
The form collects only the questions you add and shows your consent line. Following the Personal Data Protection Law (PDPL) is still your job: ask only what you need, say why, and link your privacy notice.
Can I write the form in Arabic?
Yes. Questions, options and the thank-you message are free text, so you can write them in Arabic and English.

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