Appointment request form template

Free appointment request form
template, HTML and React.

For clinics, salons, studios and consultants who confirm appointments by hand. Visitors ask for a date and a time of day, and you reply to book it.

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The code includes the fields, the CSS for the style you chose and a hidden anti-spam field. Replace the placeholder endpoint with your own before publishing, or open it in the designer to change fields, colors and wording without touching code.

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appointment-request-form.html

<style>
.formkoi-form, .formkoi-form * { box-sizing: border-box; }
.formkoi-form { width: 100%; max-width: 560px; padding: clamp(20px, 5vw, 36px); background: #ffffff; color: #233c34; font: 16px/1.5 system-ui, sans-serif; border: 1px solid #233c3430; border-radius: 8px; }
.formkoi-form h2 { margin: 0 0 8px; font: inherit; font-size: 28px; font-weight: 600; line-height: 1.2; overflow-wrap: anywhere; }
.formkoi-form > p { margin: 0 0 20px; overflow-wrap: anywhere; }
.formkoi-fields { display: grid; grid-template-columns: 1fr 1fr; gap: 20px 15px; }
.formkoi-field { grid-column: 1 / -1; display: grid; gap: 6px; min-width: 0; }
.formkoi-field--half { grid-column: span 1; }
.formkoi-fields label, .formkoi-fields legend { font-size: 14px; font-weight: 500; overflow-wrap: anywhere; }
.formkoi-fields input:not([type=checkbox]):not([type=radio]):not([hidden]), .formkoi-fields textarea, .formkoi-fields select { display: block; width: 100%; min-width: 0; padding: 12px; border: 1px solid #233c3470; border-radius: 8px; background: #ffffff; color: #233c34; font: inherit; }
.formkoi-fields select { appearance: auto; }
.formkoi-fields textarea { min-height: 120px; resize: vertical; }
.formkoi-fields input::placeholder, .formkoi-fields textarea::placeholder { color: #233c3480; }
.formkoi-fields input[type=file] { padding: 10px; }
.formkoi-choices { margin: 0; padding: 0; border: 0; min-width: 0; }
.formkoi-choices legend { padding: 0; margin-bottom: 6px; }
.formkoi-choices label, .formkoi-check { display: flex; align-items: flex-start; gap: 10px; font-weight: 400; cursor: pointer; }
.formkoi-choices label + label { margin-top: 8px; }
.formkoi-choices input, .formkoi-check input { width: 18px; height: 18px; margin: 3px 0 0; flex: none; accent-color: #233c34; }
.formkoi-help { margin: 0; font-size: 13px; opacity: .75; overflow-wrap: anywhere; }
.formkoi-fields .cf-turnstile { grid-column: 1 / -1; }
.formkoi-fields button { grid-column: 1 / -1; justify-self: start; margin-top: 12px; padding: 12px 22px; border: 0; border-radius: 8px; background: #233c34; color: #ffffff; font: inherit; font-weight: 600; cursor: pointer; overflow-wrap: anywhere; max-width: 100%; }
.formkoi-fields button:hover { filter: brightness(.94); }
.formkoi-fields :focus-visible { outline: 2px solid #233c34; outline-offset: 3px; }
@media (max-width: 480px) { .formkoi-field--half { grid-column: 1 / -1; } }
</style>
<section class="formkoi-form" aria-label="Request an appointment.">
<h2>Request an appointment.</h2>
<p>Choose a date that suits you and we’ll confirm the time by email.</p>
<form class="formkoi-fields" action="https://api.formkoi.com/f/YOUR_PUBLIC_FORM_KEY" method="POST">
  <div class="formkoi-field formkoi-field--half">
  <label for="name">Your name</label>
  <input id="name" name="name" autocomplete="name" required>
  </div>
  <div class="formkoi-field formkoi-field--half">
  <label for="email">Email address</label>
  <input id="email" name="email" type="email" autocomplete="email" required>
  </div>
  <div class="formkoi-field formkoi-field--half">
  <label for="phone">Phone number</label>
  <input id="phone" name="phone" type="tel" autocomplete="tel" required>
  </div>
  <div class="formkoi-field formkoi-field--half">
  <label for="service">Service</label>
  <select id="service" name="service" required>
    <option value="">Choose one</option>
    <option value="Consultation">Consultation</option>
    <option value="Follow-up">Follow-up</option>
    <option value="Treatment">Treatment</option>
  </select>
  </div>
  <div class="formkoi-field formkoi-field--half">
  <label for="date">Preferred date</label>
  <input id="date" name="date" type="date" required>
  </div>
  <fieldset class="formkoi-field formkoi-choices formkoi-field--half">
    <legend>Preferred time</legend>
    <label><input type="radio" name="time" value="Morning" required> Morning</label>
    <label><input type="radio" name="time" value="Afternoon" required> Afternoon</label>
    <label><input type="radio" name="time" value="Evening" required> Evening</label>
  </fieldset>
  <div class="formkoi-field">
  <label for="message">Notes</label>
  <textarea id="message" name="message" placeholder="Anything we should know before your visit."></textarea>
  </div>

  <!-- Leave this hidden anti-spam field empty. -->
  <input type="text" name="botcheck"
    tabindex="-1" autocomplete="off" style="display:none" hidden>

  <button type="submit">Request appointment</button>
</form>
</section>

New to connecting a form? The HTML contact form guide and the React contact form guide walk through pointing any of these templates at your endpoint.

Fields in this appointment request form.

A date picker avoids ambiguous formats. Time of day is multiple choice because exact slots change; you confirm the time in your reply.

Label	Field name	Type	Required
Your name	`name`	Short text	Yes
Email address	`email`	Email	Yes
Phone number	`phone`	Phone	Yes
Service	`service`	Dropdown: Consultation, Follow-up, Treatment	Yes
Preferred date	`date`	Date	Yes
Preferred time	`time`	Multiple choice: Morning, Afternoon, Evening	Yes
Notes	`message`	Long text	No

Field names are what arrive with each message and what routing rules match on. The email field is used for replies and auto-replies.

Make it yours in minutes.

Change fields without code

Open the template in the visual designer to add, remove or reorder fields, switch input types, and set labels, placeholders and help text.

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Match your website

Pick a style preset, then adjust colors, typography, corners and spacing. Copy fresh HTML or a React component whenever you change it.

Connect one endpoint

Create a form, verify a recipient, and paste the code. Submissions land in your inbox with spam review, routing and delivery tracking.

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Related templates.

Frequently asked questions

Appointment request form
questions.

Does it check availability?

No. This is a request form. You confirm the time in your reply, which keeps your calendar tool in charge of availability.

Can I send a confirmation automatically?

Yes. Turn on Turnstile and auto-replies for the form, then add an unchecked consent checkbox. Visitors who tick it get an acknowledgement; you still confirm the time yourself.

Can requests go to my booking software?

Forward each submission with a signed webhook to any tool that accepts JSON.

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Free appointment request formtemplate, HTML and React.