A health check package booking form for wellness clinics and hospitals — the patient picks a package, adds optional screenings, completes a mini-intake and books a slot in one flow.
Quick answer
A health check package booking form lets the patient pick a package, add optional screenings, complete a mini-intake and book a slot in one flow — the front desk receives a complete packet.
Disclaimer: this page and its AI report are for self-reflection and process reference only. They do not constitute medical, psychological, financial, legal or safety advice. Consult a qualified clinician before making care decisions.
Health checks go wrong when the package chosen does not fit the patient (a smoker without a lung CT, a family-history-of-cardiac-disease patient without lipid testing). This booking form captures package, optional screenings and a mini-intake (age, sex, smoking, family history, prior diagnoses) so the front desk can flag mismatches before the appointment.
Try the actual running form — not a screenshot — before you copy it.
Everything you need to run this template.
From copy to deliverable in four steps.
Copy the form and its branding settings into your FormLM workspace — free; you can upgrade to a scored assessment with an AI PDF report any time.
Adjust fields, options and consent language to match your clinic workflow.
Send the link or QR; every response is captured automatically.
Export or review the collected responses at any time from one dashboard.
Pick your role — see how it fits your clinic workflow.
Every booking arrives with the right package and add-ons suggested.
Front desk flags mismatches before the patient arrives.
Same form for employees and spouses; results aggregate by company.
What makes this template work as a professional clinical deliverable.
A preview of real fields patients see — the full version is a live form — responses are captured automatically and can be exported at any time.
