Beautiful forms.
Built for real workflows.

Collect intake details, consent, uploads, booking information and customer updates without pushing your team into another tool.

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Add block
Short text
Long text
Title
Radio buttons
Checkboxes
Date of birth
Email
Contact number
Linear scale
Weight
File upload
Signature
New patient intake
Full name *
Date of birth *
DD / MM / YYYYâ–¾
Have you been diagnosed with any of the following? *
High blood pressure
Type 2 diabetes
None of the above
Any additional notes

Describe the job.
Olly drafts the form.

Give Olly the use case: intake, consent, uploads, check-ins or follow-ups. It drafts the form structure, then you tidy up the details.

AI Generate from a prompt
Create a Mounjaro patient intake form with medical history, current medications, weight, blood pressure and a consent section
Try an example
Start from a template
New patient intake
8 fields
Prescription check-in
6 fields
Consent form
5 fields
Fitness assessment
10 fields
Style consultation
7 fields
Onboarding
4 fields

Know your client
before they arrive.

Send forms before bookings, after orders, during subscription reviews or from a simple shared link. Your team gets the answers, uploads and notes where they need them.

  • Pre-appointment intake Ask the important questions before the client turns up.
  • Uploads before arrival Collect photos, documents or supporting files ahead of time.
  • Consent and declarations Get confirmations recorded before the appointment starts.
  • Linked to the booking Keep the answers attached to the right client and appointment.
Mounjaro intake form
Page 1 of 3 · Please answer honestly — this helps us tailor your treatment.
Current weight *
92 kg
Have you taken any weight loss medication before? *
Yes — Wegovy previously
No, this is my first time
How would you rate your current energy levels? *
1
2
3
4
5

Not just
text boxes

Build proper customer forms with uploads, signatures, dates, ratings, contact fields and structured answers, without needing a developer.

Short & long text
Single-line answers, longer notes and open-ended questions.
Radio buttons
Let customers choose one answer from a fixed list.
Checkboxes
Useful for symptoms, preferences, consent points or multi-select answers.
Dropdowns
Keep longer lists tidy, like countries, medications, services or dosages.
Date of birth
A dedicated DOB field with validation, so your team is not cleaning up formats later.
Scale / rating
Ask for pain scores, satisfaction, energy levels or any other scored answer.
Height & weight
Collect height and weight with unit options built in.
File upload
Collect photos, documents, test results or supporting evidence.
Signature
Capture a digital signature for consent, declarations or approvals.
Email & phone
Validated contact fields, checked before the form is submitted.
Headers & spacers
Break longer forms into clear sections so they are easier to complete.
Page breaks
Split longer forms into steps instead of showing everything at once.

Only ask what's
actually relevant.

Add rules like "only show this if they selected yes". Show follow-up questions, warnings or extra instructions only when they apply, instead of making everyone read through the same form.

  • Build rules visuallyChoose the question, the answer and the condition, then Priorly handles when it appears.
  • Show guidance when it mattersDisplay extra instructions, warnings or next steps based on the customer’s answer.
  • Use AND / OR rulesCombine answers for more detailed pathways, without writing custom logic.
  • Skip what does not applyHide questions, fields or sections the customer does not need.
Do you have any medical conditions?
Yes
No
Shown because answer is Yes
Please list your medical conditions
Display condition
Only show if
Do you have medical conditions?
Yes
is selected
Page 2 of 3

Forms that know
who they're talking to.

Use customer, booking, order or subscription details inside the form. Names, answers and known details can be pulled in automatically, so the form feels connected to the workflow it belongs to.

  • Pre-fill via URLSend a link with details already attached, so email campaigns, QR codes and follow-ups can open with the right context.
  • Auto-fill from portalLogged-in customers do not need to retype details already saved against their profile.
  • Reference earlier answersBring a previous answer into a later question, warning, note or confirmation message.
  • Works in normal textPlaceholders can sit inside headings, helper text, labels and messages, not only fields.
Shared link
everygreen-clinic.co.uk/forms/intake?firstName=Dan
Evergreen Health Clinic
Patient Intake Form
Hi Dan!
Before your appointment, we just need a few details. This should take about 3 minutes.
Full name *
Dan
Email address *
[email protected]
Amanda Reynolds is logged in - known fields pre-filled automatically
Evergreen Health Clinic
Monthly Check-in
Welcome back, Amanda
Full name
Amanda Reynolds Auto-filled
Date of birth
14 / 03 / 1988 Auto-filled
Current weight *
Enter your weight
Evergreen Health Clinic
Patient Intake Form
Earlier answer
Have you taken weight loss medication before?
Yes - Wegovy previously
You mentioned Wegovy previously - how long were you on it, and why did you stop?
About 6 months. Side effects got quite bad towards the end.
{{previousMedication}} replaced with their earlier answer

Forms that look like
yours.

Match the form to your brand with colours, fonts, spacing and layout controls. Keep it simple, or add custom CSS when you need finer control.

Brand styling
Set colours, fonts, buttons, borders and spacing without touching code.
Layout control
Arrange fields into rows, columns and pages so longer forms still feel tidy.
Extra control when needed
Use the simple styling options, or add custom CSS for more detailed brand work.
Default styling
Background
Primary colour
Main font
Inputs
Text
Background
Placeholder
Roundness
Full name
Your full name
Email address
[email protected]
Your choice
Option one
Option two

Forms for the details
your team needs.

Use forms before bookings, after orders, during subscription reviews, or from a simple link. Intake, consent, check-ins and feedback stay tied to the customer workflow.

New client intake
Collect history, preferences, uploads, declarations or consent before the first booking, order or consultation starts.
ClinicsBookingsMulti-page
Treatment check-ins
Ask for weight, side effects, photos, blood pressure or review answers before the next renewal, dispatch or appointment.
SubscriptionsTask gatingReviews
Consent forms
Capture signatures, confirmations and declarations, then keep the completed form against the customer record.
SignatureConsentCustomer record
Fitness assessments
Gather goals, injuries, current ability and progress photos before a PT session, plan review or programme start.
GymsPersonal trainersUploads
Onboarding forms
Ask the questions every new customer needs to answer once, then use those details across bookings, orders and future forms.
All businessesPre-fillProfile setup
Feedback and follow-ups
Send a link after an order, appointment or service. Use it for reviews, issues, aftercare checks or simple customer feedback.
Shared linkQR codeAftercare

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