Get written permission to charge a card without chasing paper forms — one secure link, signed in under two minutes from any phone.
A credit card authorization form template that captures cardholder name, card details, billing address, charge amount, and a signed acknowledgement in one shareable link. Built for hotels, clinics, agencies, and any business that needs documented consent before running a recurring or card-not-present charge.
15 fields — customize any field or add new ones with AI.
Need different fields?
Tell the AI what to change — "add a budget dropdown" or "remove phone number" — and it edits the form instantly. Every field type above can be added, removed, or relabeled through the chat interface.
Everything you need to launch this form in minutes, share it with your team, and collect submissions reliably.
A real drawn signature field — not just a typed name — gives you the same legal weight as a paper authorization in most jurisdictions, with an attached timestamp and IP address.
Captures only the last 4 digits of the card by default so your form storage never holds a full PAN. Full card numbers should be entered through your payment processor, not the form.
A single radio field lets the cardholder pick between authorizing a single charge or a recurring schedule, with conditional end-date capture for the recurring case.
Cardholders draw their signature with a finger or stylus on any phone, tablet, or laptop — no app install, no DocuSign account.
Once submitted, the cardholder receives a copy of the signed authorization for their records, which is what most card issuers expect to see in a dispute.
Every submission can be exported as a PDF or pushed to Google Sheets with the full field set, signature image, timestamp, and submitter IP for compliance review.
Click "Use this template free." Flexform loads the form instantly — no account needed to preview.
Type what you want to change in the chat: fields to add or remove, rename labels, change field types, or rearrange pages.
Link to Email or Google Sheets with one click, then embed on your site or share the link.
A guest books a room with a corporate card but the cardholder isn't the one checking in. Front desk sends a credit card authorization link to the cardholder, who signs it from their office before the guest arrives, covering any incidental charges to the room.
Clinics use the form to capture authorization for copays, no-show fees, or installment payments on procedures not fully covered by insurance. The signed record is filed with the patient chart for compliance.
A marketing or design agency closes a new client on a monthly retainer. Instead of a PDF round-trip, they send the authorization form with the start date, monthly amount, and a 12-month end date. The client signs, billing starts the next cycle.
A mechanic discovers a second issue mid-repair that pushes the bill 30% over the estimate. They send a quick authorization form with the new total and reason, the customer signs from the waiting room or work, and the job continues without a billing surprise.
A pet owner extends a boarding stay or approves an unexpected vet procedure while traveling. The authorization form captures the new amount and reason in writing so the facility has documented consent for the additional charge.
Rental companies use the form to hold authorization for a damage deposit separately from the rental charge itself, with a clear description of what the deposit covers and when it will be released.
Connect this form to your existing tools with no middleware. Every submission triggers your workflow automatically.
Data appears in your CRM or spreadsheet within 1–2 seconds of submission — no cron jobs, no delays.
Route submissions to different Slack channels, HubSpot pipelines, or Airtable bases based on field values.
Pre-fill form fields with CRM data for returning visitors. Update existing records instead of creating duplicates.
In most US states and many other jurisdictions, a credit card authorization with a clear amount, reason, and signature carries the same weight as a paper form. The key elements are documented consent and an audit trail — both of which a digital form captures more reliably than a faxed PDF. Always check your local rules and your card processor's requirements.
No — and the template is intentionally designed to capture only the last 4 digits. Storing full card numbers (PANs) makes you subject to PCI DSS compliance requirements, which most small businesses are not set up to meet. Take the full card number through your payment processor (Stripe, Square, your POS) and use this form only for the written authorization.
Yes. Open the form in the FlexForm editor and describe what you want changed in plain English — "add a HIPAA acknowledgement before the signature" or "change the consent paragraph to cover monthly retainer billing." The AI edits the form for you without needing to rebuild fields from scratch.
The cardholder draws their signature with a finger or mouse in a dedicated signature field. The image is saved as part of the submission record along with a timestamp and IP address, which is the standard chain of evidence a card network looks for if a charge is later disputed.
By default you get an email notification with every submission. From there you can push to Google Sheets for your finance team, send a Slack message when a high-value authorization comes in, or webhook the data into your billing or CRM system — all configured from the workflow tab without code.
Yes. The form works as a shareable link, an iframe embed on your website, or — if you have a native Android or iOS app — through the Kotlin Multiplatform mobile SDK so cardholders complete the authorization without leaving your app.
Most card processors recommend keeping authorization records for at least 18 months after the last charge, since that's the outer window for most chargeback disputes. Some industries (healthcare, hospitality) have longer retention rules — check yours. FlexForm keeps submissions indefinitely on paid plans and you can export them to your own storage anytime.
Yes. The free forever plan covers form creation, the share link, signature capture, and a generous monthly submission count — enough for most small operations teams. Paid plans unlock higher volumes, team seats, and removal of the FlexForm footer.
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No signup required · Free forever plan