Capture every detail a reflexologist needs before the first session — medical history, foot conditions, goals and signed consent in one shareable intake.
A complete reflexology intake form that walks new patients through their health background, current symptoms, foot and lower-limb conditions, and treatment expectations. Practitioners get a signed consent and a clean record before the patient ever sits in the chair.
16 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 dedicated checkbox section surfaces conditions like diabetes, DVT history, or pregnancy so the practitioner sees them before the session starts.
Patients sign on their phone with a finger or stylus, and the signature is stored with the rest of the record as part of the submission.
Patients can attach recent imaging, podiatry reports, or referral letters directly to their intake instead of bringing paper copies.
Long-form fields like medical history render cleanly on small screens, so older patients don't have to pinch and zoom through a desktop layout.
New intakes drop into a Google Sheet for the front desk and trigger an email to the assigned reflexologist within seconds.
Reuse the same link for follow-up visits with shorter "what's changed" prompts instead of a full rewrite of the history.
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 Google Sheets or Slack with one click, then embed on your site or share the link.
A solo reflexologist sends the link the day before each first appointment. Patients arrive with consent already signed and history reviewed, which turns a 60-minute slot into 55 minutes of actual treatment.
Reception books the patient, the form auto-routes to the assigned therapist by Slack, and every record lands in a shared Google Sheet for the practice manager to audit weekly.
Reflexology offered alongside oncology or palliative care requires a stricter history — current chemo cycle, lymphedema status, neuropathy. A tailored version of this form captures it without forcing patients onto the hospital's heavyweight EMR.
Student practitioners use the same intake under supervision. Instructors review submissions before the session and use the record afterwards for case-study assessment.
No paper, no printer, no clipboard. The practitioner pulls up the signed intake on their tablet between visits and adds session notes back to the same record.
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.
FlexForm provides the form and storage infrastructure, but HIPAA compliance also depends on how your practice handles the data downstream. For US-based clinical use, talk to our team about a Business Associate Agreement and configure integrations to keep PHI within compliant systems.
Yes. The signature field works on touchscreens with a finger or stylus and on desktop with a mouse or trackpad. The signed image is stored with the submission and is admissible as written consent in most jurisdictions where electronic signatures are recognized.
Open the form in the editor and describe the change in plain English — for example, "add cardiac stent and remove the pregnancy section." The AI updates the field set and you can save it as your default version.
Yes. You can either send a shorter follow-up version of the form for return visits, or pre-fill the original with their previous answers and ask them to confirm what's changed. Both approaches keep the audit trail intact.
Set up a Slack notification, an email alert, or a webhook into your scheduling tool. Most practices use Slack for the assigned therapist and a Google Sheets log for the front desk.
Yes. The Kotlin Multiplatform mobile SDK lets you embed the same form inside a native Android or iOS app, keeping the consent and signature flow intact without rebuilding the form twice.
The free forever plan covers a typical solo practice — unlimited form views, a reasonable monthly submission allowance, and all the integrations mentioned above. You only need a paid plan once you outgrow the submission cap or want custom branding and domains.
The file upload field accepts PDFs, images, and most common document formats up to the size limit on your plan. Patients can attach podiatry reports, recent imaging, or referral letters directly to their intake.
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No signup required · Free forever plan