Creating a Form

Forms are designed to collect lead information, whether that lead is a patient returning to care or a new opportunity. Once you’ve created a form, you can include it on any landing page, meaning that forms are not specific to the landing page they were created on.

Note: Forms can only be created or edited within the Hero block of a landing page.

  1. Within the landing page, click the Hero block to edit.                                  
  2. In the Select a form section, choose a form from the drop-down menu or click Create Form.
  3. When creating a new form, you’ll be required to Name the form. Adding a Description is optional. Click Next to continue.
  4. You’ll remember from our Landing Pages Best Practices that requiring the lead to fill in too much information dissuades them from completing the form. Determine how much information you actually need to schedule the patient and don’t ask for more than that.
  5. The Create Form window defaults to First Name, Last Name, Email (required), and Message. These can all be updated from the Form Fields section on the right.                                             
  6. Click Add Field. You can add any of these fields (described in the table below) and determine whether or not they’re required. We’ll include Phone Number.                                                                                    
    1. First Name
    2. Last Name
    3. Phone Number
    4. Email
    5. Message
    6. Lead Source
    7. Referring Provider Name
    8. Preferred Appointment Day
    9. Preferred Appointment Time
    10. Preferred Facility
    11. Preferred Provider
    12. Services
  7. To reorder the form fields, click and drag.
  8. For each field, you incorporate multiple options such as a default value or make a field required.
  9. Below the Form Fields section, you can choose the form Heading and Submit Button text.
    1. You may find that the form Heading conflicts with the Hero block heading and simply leave the Form Heading blank to reduce distractions.
    2. Ensure the Submit Button text correlates with the action they’re taking. Statistically speaking, Click Here and Go rank higher for clicks than Submit. Though often, Sign Up could also be an effective button text.
  10. Near the Create Form or Edit Form title, you’ll have an Options tab; select this.
  11. Here, you can choose to display a custom Thank You message when the form is submitted or redirect the user to another page. Remember from our Best Practices that you should always include a Thank You and provide information about when they should expect someone to reach out to them.

Available Form Fields

Field Name Type Notes
First Name Contact first name
Last Name Contact last name
Phone Number Contact’s preferred phone number.
Email Contact’s preferred email address.
Message A free text field for your contact’s to enter information, or a response to a question you have asked.
Lead Source Where is this lead coming from? A 5k tent? A specific event? Hide this field with default text so your contact doesn’t have to fill it in.
Referring Provider Name The name of the provider who submitted a patient’s referral.
Preferred Appointment Day Calendar Picker
Preferred Appointment Time Drop-down Selection (Morning, Afternoon, Evening)
Preferred Facility Drop-down Selection. Determine whether to populate with all available facilities or select from a list. Facilities can be updated (including renamed) in your Settings.
Preferred Provider Drop-down Selection. Determine whether to populate with all available providers or select from a list. Note: additional providers can be specified in your Settings.
Services Drop-down Selection. Determine whether to populate with all available services or select from a list. Note: services can be added or updated in your Settings.

Available Form Field Options

For each field you add to the form, you can customize it with the following options.

Field Options Description
Label This is the label that appears above the entry box. For example, Phone Number.
Help Text Any text entered into this field will appear when the (?) icon is hovered.
Placeholder Text Appears in the field and will be overwritten when the lead begins data entry. This is typically used to provide a particular format for entry.
Default Value The field will default to whatever is entered in this box or selected from the drop-down. This is primarily used in conjunction with the Hide this field checkbox described below. This allows you to associate specific data with a lead. This is useful when creating multiple landing pages for different lead sources, like events or referring providers.
Require this field Indicated by an asterisk. The form cannot be submitted without data being entered in this field.
Hide this field Leads will not see this field on the form. However, if a default value was entered, this value will be associated with the lead when the form is submitted.
Remove Field This button deletes the field from the form. Don’t worry, you can always re-add the field if you determine you need it later.

Editing a Form

You can edit a form in the Select a form section. Simply choose the form from the drop-down and use the Edit link.

Pre-filling Form Fields

For leads associated with a patient record (these are your past patients), we can pre-fill the lead form with certain data, like first and last name.

Click herefor more information.

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